| HCPCS Code: |
E1220 |
| Long Description: |
Wheelchair; specially sized or constructed, (indicate brand name, model number, if any) and justification |
| Short Description: |
Whlchr special size/constrc |
| Pricing Indicator 1: |
45 (Customized DME items) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| Coverage Issues Manual 1: |
60-6 |
| Statute Number: |
|
| Coverage Code: |
D (Special coverage instructions apply) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
D1D (Wheelchairs) |
| Type of Service Code 1: |
P (Lump sum purchase of DME, prosthetics, orthotics) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-01-1986 |
| Action Effective Date: |
01-01-1990 |
| Action Code: |
N (No maintenance for this code) |
