The Durable Medical Equipment Medicare Administrative Contractors (DME MACs) have recently identified an unbundling issue related to walkers (E0141, E0143 and E0149) and brake attachments (E0159). This article provides clarification on when it is appropriate to bill the (DME MACs) separately for walkers and brake attachments.
Upon initial issue of an E0141, E0143 and E0149, if brakes are being provided at the same time, the charges are included in the reimbursement for the walker and may not be billed separately to the DME MACs or the beneficiary. The following table can be found in the walkers policy article. Note the status of the brake attachments (E0159).
A Column II code is included in the allowance for the corresponding Column I code when provided at the same time and must not be billed separately at the time of billing the Column I code.
COLUMN I COLUMN II
E0130 A4636, A4637
E0135 A4636, A4637
E0140 A4636, A4637, E0155, E0159
E0141 A4636, A4637, E0155, E0159
E0143 A4636, A4637, E0155, E0159
E0144 A4636, A4637, E0155, E0156, E0159
E0147 A4636, E0155, E0159
E0148 A4636, A4637
E0149 A4636, A4637, E0155, E0159
Below is a reference regarding each HCPCS code and description for the above table:
HCPCS Code Description
A4636 REPLACEMENT, HANDGRIP, CANE, CRUTCH, OR WALKER, EACH
A4637 REPLACEMENT, TIP, CANE, CRUTCH, WALKER, EACH.
E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT
E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT
E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE
E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT
E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT
E0144 WALKER, ENCLOSED, FOUR SIDED FRAMED, RIGID OR FOLDING, WHEELED WITH POSTERIOR SEAT
E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE
E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH
E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE
E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR
E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH
Note: HCPCS code E0159 (Brake attachment for wheeled walker, replacement each) is applicable for replacement brakes ONLY.
For questions about correct coding, contact the PDAC Contact Center at (877) 735-1326 between the hours of 8:30 a.m. and 4:00 p.m. CT, Monday through Friday.
