2024 HCPCS Code E2617

Custom fabricated wheelchair back cushion, any size, including any type mounting hardware

Short Description	Custom fab w/c back cushion
HCPCS Coverage Code	C - Carrier judgment
HCPCS Action Code	N - No maintenance for this code
HCPCS Action Effective Date	January 01, 2005
HCPCS Code Added Date	January 01, 2005
HCPCS Pricing Indicator Code	32 - Inexpensive & routinely purchased DME (price subject to floors and ceilings)
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Coverage Issues Manual Reference Section Number
HCPCS Type Of Service Code	A - Used durable medical equipment (DME)
HCPCS Anesthesia Base Unit Quantity	0