Simplifying CRT Billing: New HCPCS Codes Make Accessory Claims Easier

Published in Complex Rehab on April 24, 2025

Dan Fedor This post was originally featured in HME News.

CMS’s decision to revise and expand E1028 (swing-away mounting hardware) and create three new HCPCS codes based on where it's being used on a wheelchair is a "win” for the industry because it will make it easier for providers to bill for these devices, says Dan Fedor.

Fedor, director of reimbursement and education for U.S. Rehab, says the changes, which went into effect for dates of service on or after April 1, mean that, for the most common accessories where swing-away mounting hardware is added, providers no longer need to include extra narrative in their claim.

“For example, the new code E1033 is for swing-away mounting hardware used on a headrest – ‘wheelchair accessory, manual swing-away, retractable or removable mounting hardware for headrest, cushioned, any type’ – and, therefore, no narrative is required,” he said.

A joint DME MAC publication in March announced the updates:

Revise existing HCPCS Level II code E1028, "Wheelchair accessory, manual swing-away, retractable or removable mounting hardware for joystick, other control interface or positioning accessory" to instead read "Wheelchair accessory, manual swing-away, retractable or removable mounting hardware, other"
Establish a new HCPCS Level II code E1032, "Wheelchair accessory, manual swing-away, retractable or removable mounting hardware used with joystick or other drive control interface."
Establish a new HCPCS Level II code E1033, "Wheelchair accessory, manual swing-away, retractable or removable mounting hardware for headrest, cushioned, any type"
Establish a new HCPCS Level II code E1034, "Wheelchair accessory, manual swing-away, retractable or removable mounting hardware for lateral trunk or hip support, any type"

Prior to the changes, Fedor says, E1028 was a more generic code and, therefore, required a note indicating where the accessory was being used on a wheelchair for every instance.

“For example, if swing away mounting hardware E1028 is being used on the joystick, the extra narrative claim line would need to include ‘used on E2374’ and if the E1028 was used on the head rest, the extra narrative claim line would need to include ‘used on E0955’ and so on,” he said.

If swing-away is being used on an accessory that doesn't fall under one of the three new codes (for example E0953), Fedor said providers should use E1028 and still include a narrative of where it is being used.

In their publication, the DME MACs noted that E1032, E1033 and E1034 are in the capped rental payment category, but they will have the first-month purchase option when used on K0835-K0864 bases.

At press time, the fee schedules for the new codes had not been posted, but Fedor said the word on the street is that they will follow the same allowable as E1028.

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