Friday, April 19, 2024

E codes- Responses

Randall McFarland, CPO

Here is the ORIGINAL QUESTION:
Is anyone familiar with “E Codes”?
For instance,”E 1800″ “Bi-directional static progressive stretch elbow
device with ROM adjustment, includes cuffs”
The list I have goes from E1800-E1810 for similarly worded “static
progressive stretch” devices.
What profession uses these codes and who manufactures the items intended
for these codes?
A professional consultant sent me the list and asked me about them.

RESPONSES: (each separated by a blank line) It appears that E codes are for
rental items only. I have not heard if the items used for rentals can also be
offered for sale. Thanks to all who responded and have a good weekend!

I now have a distributorship for a product that matches these descriptions,
but it is a rental item, that the company “JAS” does all the authorization
work & the billing for the services. The items are applied by RPT’s in their
clinics like the “Dynasplint”, etc. I have yet to provide one, but am
marketing it to my PT community. I’m actualy working next Monday & Tuesday
in my area marketing the PT community with the District Manager for the
company. CO

the codes are used by Dynasplint and its sales rep force to bill for dynamic
splinting. They bill with those codes monthly and get a big return on their
products.
CP

I have not heard of the E-codes , but will begin searching. The description
sounds like an “ultraflex” or similar device for dynamically working out
contractures. Physicians in our area have been sending these patients to us
more frequently lately and we’ve had a terrible time getting reimbursed for
them. I will ask some questions, and would appreciate you forwarding or
posting the responses. CO

I believe those are HME/DME codes…wheelchairs, seating and positioning
devices, walkers, etc.

i have never heard of those.

The E codes are for various types of DME. The series is E0100
through E2101. I believe you are in DMERC Region D. You can access
the E codes at their website or in Chapter 16 of the Region D
Supplier Manual. CPO

This sounds interesting! Please post responses. Thanks. CP

These are rental DME codes to cover JAS devices used by PTs.

Sounds like new codes for the Joint Active Systems (JAS) contracture
management devices. They make units for the ankle, knee, hip, shoulder,
elbow and wrist. I have used them on many contractures secondary to trauma
with good success. I tried one on a disease related case with little
success (certainly not a fair sampling). Their # is 1-800-879-0117 if
you’d like more info. CO

I believe they are intended for DME rental items.CPO

I believe this would include Empi’s Dynamic Elbow Orthosis (Rental Code)

I think these codes are used for Occupational Therapists for their splints

DME providers use the E codes. Cane Walker etc. CP

They are not for O&P use. I would suggest calling AOPA and talking to Kathy
Dodson

Anyone who does DMEPOS services can use A,E,K,L,V and occasionally Z codes.

Check your Alimed and Sammons Preston (Preston Sammons?) catalogs. I think
you’ll find off-the-shelf items that will fit some of the E code descriptions
in there.CO

we have a contract agreement with them, we aren’t happy about. Some of our
hmo groups have ordered them because of pt pressure. When I have called
referring doctors to get a clearer history on the patients we have using
dynasplint they don’t return my calls. Maybe they don’t agree with the
dynasplint costs either. This dynamic system is but one more way we have been
removed from the extended care and treatment of patients in our communities.
As far as billing goes, we have to re-submit an ‘L’ code to the referral
source monthly (2999). Hoping it goes through smoothly, historically none
have been easy. The owner of my facility is monitoring every case we have
with dynasplint and is ready to pull the plug if we are on the losing end.
When at all possible if we can justify the change we use empi or the system
from royce and bill the one-time fees for a dynamic brace they keep. The
savings are easy to get the referring source to approve. Dynasplint doesn’t
sell, they never have as far as I know, and don’t plan to. Taken out of the
loop is hard to cope with, diplomatically. We do everything we can to stay in
there and be a part of every referral submitted to us.

The E codes are “DME” codes, distinct from O&P L-codes, but accessible to
us for billing certain DME items/procedures. We have done some offbeat
O&P custom items that we tried to bill as Lxx99 unlisted procedure codes,
with a descriptor, had NYS Medicaid prior approval deny them, and advise
us to use an E-code that they felt “covered” the descriptor for that
particular device/procedure.
That has been my limited experience with the E-codes, hope it helps.

Sounds like they could be Dyna Splints or Pro Splints.
These devices would be used for contractions of upper or lower limbs instead
of serial casting.

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