HCPCS Code Section: HCPCS E Codes

Extremity belt/harness Short Description: Belt/harness extremity Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1985 Effective Date: January 1, 1996 Termination Date:

Pelvic belt/harness/boot Short Description: Pelvic belt/harness/boot Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1985 Effective Date: January 1, 1996 Termination Date:

Cervical head harness/halter Short Description: Cervical head harness/halter Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1986 Effective Date: January 1, 1986 …

Gravity assisted traction device, any type Short Description: Gravity assisted traction de Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …

Trapeze bar, free standing, complete with grab bar Short Description: Trapeze bar free standing Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: …

Continuous passive motion exercise device for use other than knee Short Description: Cpm device, other than knee Coverage Code: Non-covered by Medicare Action Code: No maintenance for this code …

Continuous passive motion exercise device for use on knee only Short Description: Cont pas motion exercise dev Coverage Code: Special coverage instructions apply Action Code: No maintenance for this …

Fracture frame, free standing, includes weights Short Description: Fracture frame free standing Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, …

Wheelchair accessory, positioning belt/safety belt/pelvic strap, each Short Description: W/c acc,saf belt pelv strap Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, …

Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot Short Description: Foot box, any type each foot Coverage Code: Carrier judgment Action Code: No maintenance …