
Basic Adjustable Walker
An Adjustable Walker has an aluminum tubular frame with four adjustable legs to accommodate the patient’s height. Can be folded for ease of storage, or may be non-folding and ridged. The Walker also has handgrips to aid the patient. To utilize the walker, the patient positions himself into it gaining three-sided support as he steps forward.
HCPCS Code:
E0135 - folding walker
E0130 - non-folding walker
E0148 - heavy duty walker
Category:
Inexpensive/Routinely
Purchased
Common Diagnosis:
(check for current coding)
781.2 Gait Abnormality
715.9 Osteoarthritis
428.0 Congestive Heart Failure
Coverage Information
Requires a detailed written order
• The patient has impaired ambulation and there is a potential for ambulation
• The patient has a mobility limitation that significantly impairs his/her ability to participate in one or more mobility-related activities of daily living (MRADL) in the home; AND
• Patient requires additional stability not provided by canes and crutches (see cane / crutch criteria) AND can safely use a walker
• The mobility deficit can be resolved with a walker
E0148: Requires KX Modifier. If a heavy duty walker (E0148) is provided and if the supplier has documentation in their records that the patient’s weight (within one month of providing the walker) is 300 pounds or more, the KX modifier should be added to the code. The KX modifier may only be used when documentation regarding the patient’s weight is on file.
E0158: Leg extensions added as an additional code when there is documentation that the patient is greater than or equal to 6 feet tall.
E0156: Used when a platform seat attachment is added to the walker – no additional requirements if patient is qualified for a walker.
E0147: A heavy duty, multiple braking system, variable wheel resistance walker (code E0147) is covered for patients who meet coverage criteria for a standard walker AND who are unable to use a standard walker due to a severe neurologic disorder or other condition causing the restricted use of one hand. Demonstrate via diagnosis code. The claim should be submitted with a narrative comment in Box 19 to include the manufacturer’s name, and model ame/number of the product.
Note 1: A patient is not covered for an ambulatory aide such as a cane or walker AND a wheelchair at the same, UNLESS there is documentation in the medical record that the patient is in a gait retraining program via physical therapy. In that case, the wheelchair would be covered for a maximum of 6 months. Ensure that the patient is in physical therapy for gait retraining, and enter "Pt. in gait retraining w/ [name of rehab facility]" in box 19 of the arrative record.
• Documentation Requirements: in addition to the basic Medicare documentation (proof of delivery, AOB), The detailed written order form must contain the patient’s name, and a description of the item provided, physician signature and date, and the start date of the order if different than the physician signature date.
© 2010 Domos HME Consulting Group – All Rights Reserved