Walkers - Policy Article

Revision Effective Date: 10/01/2026
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Revised: E0150 benefit category information (which noted that E0150 was noncovered), to include dates of service on or after October 1, 2025 through September 30, 2026
Added: E0150 benefit category information for dates of service on or after October 1, 2026
MODIFIERS:
Revised: KX modifier information for heavy duty walker claims, by revising “the beneficiary's weight (within one month of providing the walker) is greater than 300 pounds” to “only if all of the standard walker coverage criteria (1-3) have been met and the beneficiary's weight (within one month of providing the walker) is greater than 300 pounds,” as clarification
Added: KX modifier information for E0150 for claims with dates of service on or after October 1, 2026 when coverage criteria in the Walkers LCD (L33791) and in the Manual Wheelchair Bases LCD (L33788) have been met
Revised: GY modifier information, to include that the GY modifier must be appended to E0150 if E0150 is only to be used for mobility outside the home
Revised: “Claims lines billed with codes E0148 and E0149 without a KX, GA, GY or GZ modifier will be rejected as missing information.” to “Claim lines billed with codes E0148, E0149, and E0150 without a KX, GA, GY, or GZ modifier will be rejected as missing information.”
CODING GUIDELINES:
Added: Coding guideline information for E0150
Revised: Information describing the table that contains Column I and Column II codes, by revising “A Column II code is included in the allowance for the corresponding Column I code when provided at the same time and must not be billed separately at the time of billing the Column I code.” to “A Column II code must not be billed at the time of billing the Column I code.,” as clarification
Revised: The table that contains Column I and Column II codes, by adding a row that contains E0150 in Column I and that contains A4636, A4637, E0130, E0135, E0140, E0141, E0143, E0144, E0155, E0156, E0159, E1031, E1037, E1038, and E1039 in Column II
10/01/2026: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Revision Effective Date: 10/01/2025
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Added: “A combination wheeled walker with seat and transport chair (E0150) is noncovered as it does not meet the definition of DME.”
10/30/2025: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Revision Effective Date: 04/01/2024
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Added: “A powered walker (E0152) is noncovered as it does not meet the definition of DME.”
05/02/2024: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Revision Effective Date: 01/01/2020
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):
Removed: “The link will be located here once it is available.”
Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list


04/14/2022: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Revision Effective Date: 01/01/2020
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):
Removed: “The link will be located here once it is available.”
Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list


04/14/2022: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Revision Effective Date: 01/01/2020
CODING GUIDELINES:
Added: “(CVR)” after reference to coding verification review
Added: “(PCL)” after reference to “Product Classification List”
Added: Incorrect coding denial language for products billed using HCPCS that require written coding verification review
Revised: Reference to HCPCS code E0159 long description
04/01/2021: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Revision Effective Date: 01/01/2020
CODING GUIDELINES:
Added: “(CVR)” after reference to coding verification review
Added: “(PCL)” after reference to “Product Classification List”
Added: Incorrect coding denial language for products billed using HCPCS that require written coding verification review
Revised: Reference to HCPCS code E0159 long description
04/01/2021: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Revision Effective Date: 01/01/2020
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
Added: Section and related information based on Final Rule 1713
CODING GUIDELINES:
Revised: Format of HCPCS code references, from code ‘spans’ to individually-listed HCPCS
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Revised: Section header “ICD-10 Codes that are Covered” updated to “ICD-10 Codes that Support Medical Necessity”
ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
Revised: Section header “ICD-10 Codes that are Not Covered” updated to “ICD-10 Codes that DO NOT Support Medical Necessity”

02/20/2020: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Revision Effective Date: 01/01/2020
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
Added: Section and related information based on Final Rule 1713
CODING GUIDELINES:
Revised: Format of HCPCS code references, from code ‘spans’ to individually-listed HCPCS
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Revised: Section header “ICD-10 Codes that are Covered” updated to “ICD-10 Codes that Support Medical Necessity”
ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
Revised: Section header “ICD-10 Codes that are Not Covered” updated to “ICD-10 Codes that DO NOT Support Medical Necessity”

02/20/2020: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

03/07/2019: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This is an article and not a local coverage determination.

03/07/2019: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This is an article and not a local coverage determination.

Revision Effective Date: 01/01/2017
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Added: Billing instructions for E0147 and E1399 (previously in the LCD) and Modifier instructions
CODING GUIDELINES:
Updated: E0144 narrative to include “rigid”
RELATED LOCAL COVERAGE DOCUMENTS:
Added: LCD-related Standard Documentation Requirements Language Article

Revision Effective Date: 01/01/2017
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Added: Billing instructions for E0147 and E1399 (previously in the LCD) and Modifier instructions
CODING GUIDELINES:
Updated: E0144 narrative to include “rigid”
RELATED LOCAL COVERAGE DOCUMENTS:
Added: LCD-related Standard Documentation Requirements Language Article

Effective July 1, 2016 oversight for DME MAC Articles is the responsibility of CGS Administrators, LLC 18003 and 17013 and Noridian Healthcare Solutions, LLC 19003 and 16013. No other changes have been made to the Articles.

Effective July 1, 2016 oversight for DME MAC Articles is the responsibility of CGS Administrators, LLC 18003 and 17013 and Noridian Healthcare Solutions, LLC 19003 and 16013. No other changes have been made to the Articles.

Revision Effective Date: 11/01/2013 (April 2015 Publication)
CODING GUIDELINES:
Added: Coding guidelines to clarify billing for brakes upon initial issue.

Revision Effective Date: 11/01/2013 (April 2015 Publication)
CODING GUIDELINES:
Added: Coding guidelines to clarify billing for brakes upon initial issue.