Drop Arm Commode

This is a commode chair with adjustable legs, which support a toilet seat and removable pail for easy cleaning. This commode also has an arm that will drop to allow the patient easy side transfer to or from the commode from a bed.

HCPCS Code:

E0165 – Drop Arm Commode

Category:

Capped Rental

Common Diagnosis:

(check for current coding)

714.0 Rheumatoid Arthritis
432.9 Intra Cerebral Hemorrhage
428.0 Congestive Heart Failure
342.9 Hemiplegia Right/Left
496 COPD

Coverage Information

Requires a Detailed Written Order

Patient must be incapable of utilizing regular toilet facilities

Patient must be confined to a single room or to one level of their home environment

Patient is confined to the home and the home has no toilet facilities

A commode chair with detachable arms (E0165) is covered if the detachable arms feature is necessary to facilitate transferring the patient or if the patient has a body configuration that requires extra width.

E0168: An extra wide/heavy duty commode chair (E0168) is covered for a patient who weighs 300 pounds or more. When using this code, the supplier must have documentation in their records that the patient’s weight (within one month of providing the commode) is 300 pounds or more.

E0164/E0166: Wheeled commodes (E0164 / E0166) are not considered medically necessary and therefore are NOT covered. If patient requests a wheeled commode explain coverage guidelines and offer an upgrade through use of the Advance Beneficiary Notice (ABN) form.

Note: ALL commodes require KX modifier to document that patient is incapable of utilizing regular toilet facilities as defined above.

Documentation Requirements: in addition to the basic Medicare documentation (proof of delivery, AOB, etc.) the detailed written order form must contain the patient’s name, the start date of the order, and a description of the item.