Browse HCPCS Level II 2020 Edition

HCPCS Level II Table of Contents

E1800 - E1841  Other Orthopedic Devices

E1800
Dynamic adjustable elbow extension/flexion device, includes soft interface material
shortAdjust elbow ext/flex device
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
E1801
Static progressive stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories
shortSps elbow device
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
E1802
Dynamic adjustable forearm pronation/supination device, includes soft interface material
shortAdjst forearm pro/sup device
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
E1805
Dynamic adjustable wrist extension / flexion device, includes soft interface material
shortAdjust wrist ext/flex device
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
E1806
Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories
shortSps wrist device
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
E1810
Dynamic adjustable knee extension / flexion device, includes soft interface material
shortAdjust knee ext/flex device
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
E1811
Static progressive stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories
shortSps knee device
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
E1812
Dynamic knee, extension/flexion device with active resistance control
shortKnee ext/flex w act res ctrl
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
E1815
Dynamic adjustable ankle extension/flexion device, includes soft interface material
shortAdjust ankle ext/flex device
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
E1816
Static progressive stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories
shortSps ankle device
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
E1818
Static progressive stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories
shortSps forearm device
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
E1820
Replacement soft interface material, dynamic adjustable extension/flexion device
shortSoft interface material
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalClinical: Data
E1821
Replacement soft interface material/cuffs for bi-directional static progressive stretch device
shortReplacement interface spsd
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.03 Date of Service Edit: ClinicalClinical: Data
E1825
Dynamic adjustable finger extension/flexion device, includes soft interface material
shortAdjust finger ext/flex devc
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME3.03 Date of Service Edit: ClinicalClinical: Data
E1830
Dynamic adjustable toe extension/flexion device, includes soft interface material
shortAdjust toe ext/flex device
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalNature of Equipment
E1831
Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories
shortStatic str toe dev ext/flex
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
E1840
Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material
shortAdj shoulder ext/flex device
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
E1841
Static progressive stretch shoulder device, with or without range of motion adjustment, includes all components and accessories
shortStatic str shldr dev rom adj
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration