HCPCS Code E0978: Wheelchair Accessory, Positioning Belt/Safety Belt/Pelvic Strap, Each

## **HCPCS code E0978 documentation requirements** The documentation requirements for HCPCS code E0978follow general durable medical equipment (DME) and wheelchair accessory documentation rules as outlined by CMS and Medicare LCD policies. Key documentation includes: - Physician’s order stating medical necessity for a positioning or safety belt. - Documentation must show that the belt improves safety, positioning, or function for the wheelchair user. - Records should indicate the beneficiary’s mobility limitation and need for the accessory. - Detailed supplier notes on product provided, fittings, and instructions given to beneficiary. - Medical records must support that the equipment is reasonable and necessary for home use. - Any customization beyond standard accessories must be documented and justified.

## **HCPCS code E0978 billing requirements** HCPCS code E0978 billing requirements include the following key points and modifier usage considerations to ensure compliance with Medicare and payer-specific rules: - Bill separately using HCPCS code E0978 for each positioning belt, safety belt, or pelvic strap supplied. Each unit represents one belt or strap, and the item must be billed on a separate line item from the wheelchair base or frame. - Include applicable modifiers based on payer policies and clinical context. Common modifiers include KX, which confirms that all medical necessity documentation is on file, and GA, used when a Waiver of Liability (ABN) has been issued because Medicare is expected to deny the claim. GY applies when the item is statutorily excluded or non-covered, while GZ is used if denial is expected but no ABN was provided. RB identifies a replacement part for previously issued equipment, such as a worn or damaged belt. - Payment follows the Durable Medical Equipment fee schedule. E0978 is reimbursed according to the DMEPOS fee schedule rate, with allowable charges varying by state and carrier jurisdiction. Providers should confirm current rates through the CMS DMEPOS Fee Schedule Lookup tool. - When the wheelchair base is rented under a capped rental agreement, certain accessories (including positioning belts) may not be billed separately during the rental period unless explicitly allowed by the payer’s policy. Always verify whether the accessory is included in the bundled payment.

## **Other relevant codes** - **E0974**: Manual wheelchair accessory, anti-rollback device, each - **E0980**: Safety vest for wheelchair - **E0956**: Wheelchair accessory, lateral trunk or hip support, any type - **E0957**: Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each - **E1028**: Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other (revised version) - **E1032**: Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface - **E1033**: Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type - **E1034**: Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type - **E1226**: Wheelchair accessory, manual fully reclining back (recline greater than 80 degrees), each - **E2224**: Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each - **E2227**: Manual wheelchair accessory, gear reduction drive wheel - **E2230**: Manual wheelchair accessory, manual standing system (must have programmable control parameters for speed adjustments) - **E2327**: Power wheelchair accessory, head control interface, mechanical, proportional (should include control parameters for seat elevator, acceleration control, etc.)