HCPCS E0144: Walker, enclosed, four-sided framed, rigid/folding

Obtain a copy of the list of documentation and billing requirements needed to properly use and code HCPCS E0144 from our short guide meant to assist providers.

Use Code

## **What is HCPCS code E0144?** HCPCS code E0144, a code maintained by the Centers for Medicare and Medicaid Services (CMS), has a code description of "walker, enclosed, four-sided framed, rigid or folding, wheeled with posterior seat (also known as a seated walker or enclosed walker)" that falls under the category Durable Medical Equipment (DME) - Walking Aids and Attachments. The code pertains to a wheeled walker that has a frame that completely surrounds the user and includes an attached seat in the back (posterior or rear seat).

## **HCPCS code E0144 documentation requirements** Documentation for any walker, including E0144, must first meet the basic coverage criteria for all walkers. The specific requirements for E0144 are highly restrictive. For a walker to be covered, the beneficiary must meet all the following criteria and clearly document the complete information in the patient's medical record: - The beneficiary has a mobility limitation that significantly impairs their ability to participate in one or more mobility-related activities of daily living (MRADL) in the home. - The beneficiary can safely use the walker. - The functional mobility deficit can be sufficiently resolved with the use of a walker. Other guidelines that will be considered are the following: - Medical necessity not established: For many payers, including Medicare, the medical necessity for a walker with an enclosed frame (E0144) has not been established. - Case-by-case review: Requests for coverage of E0144 may be reviewed on a case-by-case basis, requiring detailed documentation explaining why a less costly alternative (like E0143) is insufficient.

## **HCPCS code E0144 billing requirements** When billing code E0144, healthcare providers must be aware of the following requirements/guidelines: - **Modifiers**: The NU modifier (New Equipment) is commonly used when billing for the purchase of new DME, like E0144. Other modifiers may apply based on the payer and specific circumstances (e.g., replacement, rental). - **Prior authorization**: Some state-specific Medicaid programs or private payers require prior authorization for HCPCS code E0144. Providers should verify payer-specific policies before submission. - **Payment Reduction**: Due to the unestablished medical necessity, if the basic coverage criteria for a walker are met, payment will often be based on the allowance for the least costly medically appropriate alternative, such as a standard folding wheeled walker (E0143). - **Advance Beneficiary Notice (ABN**): If the provider believes E0144 may be denied because it is not medically necessary, the beneficiary should sign an ABN to indicate financial responsibility for the item in the event of a denial. - **Accessories bundling**: The E0144 code describes a complete unit, and many accessories are considered bundled into the main payment. For Medicare, some of the following accessory codes should not be billed separately with E0144: Handgrip replacement (A4636), Tip replacement (A4637), etc.

### **Other relevant codes** - **E0143**: Walker, folding, wheeled, adjustable or fixed height - **E0140**: Walker, with trunk support, adjustable or fixed height, any type - **E0147**: Walker, heavy-duty, multiple braking system, variable wheel resistance - **E0149**: Walker, heavy-duty, wheeled, rigid or folding, any type - **E0130**: Walker, rigid (pickup), adjustable or fixed height - **E0135**: Walker, folding (pickup), adjustable or fixed height - **E0141**: Walker, rigid, wheeled, adjustable or fixed height

Frequently asked questions

Documentation must demonstrate the patient's inability to safely or functionally use a standard walker, with objective clinical rationale for the four-sided frame and seat—such as specific balance, trunk, or postural impairments—beyond mere comfort or preference.

E0143 is a Walker, folding, wheeled, adjustable or fixed height (a standard rolling walker). E0144 is a more complex device—a walker that is enclosed (a four-sided frame that surrounds the user) and has a posterior seat.

Providers should have the beneficiary sign an Advance Beneficiary Notice of Non-coverage (ABN), which informs the patient that the item is not expected to be covered by Medicare and makes them financially responsible if Medicare denies the claim.