HCPCS Code E0117: Spring-assisted crutch billing guide 2026

Key takeaways

HCPCS Code E0117 (crutch, underarm, articulating, spring assisted, each) is denied outright by traditional Medicare Part B under LCD L33733. That LCD rules that medical necessity for the device has not been established.

CMS Policy Article A52459 limits Medicare-covered crutch codes to E0110 through E0116. E0117 sits outside that covered range, so no amount of documentation makes it payable.

Billers most often miscode E0117 against E0114 and E0116, the other two underarm crutch codes. E0110 is not part of that mix-up; despite the similar number, it is actually a forearm crutch code billed as a pair.

The VA reimburses E0117 under its own Prosthetic and Sensory Aids Service fee schedule, a separate program from Medicare. Pabau’s claims management software helps billers flag an E0117 order before it reaches a doomed Medicare claim.

HCPCS Code E0117 describes a crutch, underarm, articulating, spring assisted, billed per unit as each. Traditional Medicare Part B denies this code outright, and no amount of documentation changes that outcome. The bigger risk lies in what happens next: billing E0117 to Medicare anyway, or confusing it with E0114 or E0116. Those are the two underarm crutch codes Medicare does cover.

According to CMS’s HCPCS overview, Level II HCPCS codes like E0117 form the backbone of Medicare DME billing. Getting the code selection right matters on every claim.

This guide covers why traditional Medicare denies E0117 under LCD L33733, plus the coverage and documentation rules for the crutch codes Medicare does pay. It also covers how E0117 differs from E0114 and E0116, VA and Medicaid coverage, related ambulatory aid codes, and common billing errors.

Use it alongside your claims management software workflow for a clean claim every time.

HCPCS Code E0117: Definition and code details

HCPCS Code E0117 is a Level II HCPCS code maintained by CMS. The official descriptor is: Crutch, underarm, articulating, spring assisted, each.

Three elements define the device this code covers. First, it is an underarm (axillary) crutch, meaning it provides support at the axilla and hand grip, not at the forearm.

Second, it is articulating, with a hinged joint that allows controlled flexion during the gait cycle.

Third, it is spring assisted, using an internal spring mechanism to return the crutch to its upright position between steps. All three features must be present for E0117 to apply.

The code is billed per unit (“each”), so a bilateral dispensing generates two line items. It falls within the E0100-E0199 HCPCS range covering canes, crutches, and related ambulatory aids. It is also classified as durable medical equipment (DME) under HCPCS Level II.

That classification is a coding category, not a coverage guarantee: as the next section covers, traditional Medicare Part B does not reimburse this specific code.

Why traditional Medicare denies HCPCS Code E0117

Local Coverage Determination (LCD) L33733 (“Canes and Crutches”) is explicit: medical necessity for an underarm, articulating, spring-assisted crutch (E0117) has not been established. If E0117 is ordered, it will be denied as not reasonable and necessary.

That denial happens at claim adjudication and applies regardless of how complete the Standard Written Order (SWO) or supporting clinical documentation is. CMS Policy Article A52459 (Canes and Crutches) reinforces the same limit from the coverage-policy side. It lists E0110 through E0116 as the crutch codes Medicare Part B actually reimburses, and E0117 is not among them.

A nominal fee-schedule price for E0117 (around $27.55 per unit as of 2026) does still appear in CMS’s national pricing files. That figure is a paper valuation used for administrative pricing calculations, not evidence of coverage. The LCD-level denial overrides it at claim adjudication, so submitted Medicare claims for E0117 are rejected regardless of the amount attached to the code.

For the codes Medicare does reimburse (E0110 through E0116), payment is administered through the DME Medicare Administrative Contractor (DME MAC) for the supplier’s jurisdiction. Rates vary by region under that MAC’s published fee schedule. See the CMS fee schedule lookup for current allowed amounts by location.

2026 Medicare fee schedule rates for the covered crutch codes (E0110-E0116)

DMEPOS fee schedule rates below apply to the crutch codes Medicare Part B actually reimburses: E0110 through E0116. They reflect regional pricing variation across DME MAC jurisdictions. E0117 does not receive these rates in practice.

It carries only the nominal $27.55 paper valuation described above, which is never paid out because LCD L33733 denies the claim first. The figures below are illustrative of the national average for the covered codes, and actual allowed amounts depend on the supplier’s geographic area.

Verify current rates through the PGM HCPCS lookup tool or your DME MAC’s published fee schedule.

Important: Fee schedule rates for the covered codes change annually. None of them apply to E0117, which traditional Medicare does not pay regardless of the rate on file. Always confirm current rates directly with your DME MAC before billing.

Medicare coverage criteria for the payable crutch codes (E0110-E0116)

Coverage is never automatic for any crutch code. CMS Policy Article A52459 sets the medical necessity criteria for the crutch codes Medicare Part B does reimburse: E0110 through E0116. E0117 is deliberately excluded from that covered list. The criteria below apply when a covered code, not E0117, is the one being billed. Suppliers and billing staff must confirm all of the following before submitting the claim.

• Mobility impairment: The beneficiary has a condition that impairs ambulation and requires an assistive device for safe mobility. A range of motion assessment or equivalent exam confirms it.
• Physician-ordered: A treating physician has determined the device is medically necessary and issued a Standard Written Order (SWO) prior to delivery.
• Correct device dispensed: The specific device dispensed matches one of the covered descriptors (E0110-E0116). Billing E0117 for any device dispensed will be denied at the LCD level regardless of documentation.
• Face-to-face encounter: A face-to-face encounter with the ordering physician occurred before the order was written, supporting the medical necessity determination.
• Not otherwise excluded: The item is not excluded under Medicare DME coverage (e.g., for use primarily in a nursing facility).

For the covered codes, incomplete documentation is the leading cause of a denial on review. For E0117, documentation is not the issue: the code itself is excluded from coverage, so no checklist fixes it.

Billers handling physical therapy EMR workflows should route any E0117 order back to the prescriber before submission. They should reserve the pre-claim documentation checklist for confirming E0110-E0116 orders instead.

Documentation requirements for billing the covered crutch codes (E0110-E0116)

These requirements apply once a covered code — E0110 through E0116 — is the one on the claim. No documentation makes E0117 payable under traditional Medicare. Missing paperwork is the single most common cause of denials for the codes Medicare does cover. CMS Policy Article A52459 specifies three core requirements that must be in the file before the claim is submitted.

1. Standard Written Order (SWO): Must be signed by the treating physician and received by the supplier before delivery. The SWO must include the beneficiary’s name, the order date, and a description identifying the specific crutch code billed. It must also list the quantity and carry the physician’s signature. A verbal order followed up in writing does not satisfy the SWO requirement if the item was delivered before the written order was received.
2. Face-to-face encounter documentation: The medical record must show that the ordering physician examined the patient and determined medical necessity. Office notes, discharge summaries, or therapy evaluations can satisfy this requirement when they clearly support the need for the specific device.
3. Proof of delivery: A signed delivery receipt or proof-of-delivery document confirming the beneficiary received the item is required. Without it, the claim has no delivery confirmation and is immediately vulnerable to a post-payment audit.

Keeping these documents in a standardized format reduces audit exposure. Digital forms and structured intake workflows help DME suppliers capture and store the right documentation at each touchpoint. See also medical forms management for broader documentation workflow guidance.

E0117 vs E0114 and E0116: The codes billers actually confuse it with

In practice, E0117 gets miscoded against E0114 and E0116, not E0110. E0110 is actually a forearm crutch code billed as a pair, so it is not an underarm code at all. E0114 and E0116 are the two HCPCS codes that describe the underarm crutches Medicare does cover.

Confusing either one with E0117 turns a payable claim into a denied one. The difference comes down to device design and coverage status, not patient condition.

Billing note: E0114 is billed per pair, and E0116 per unit. Mixing the two up produces a unit-count error, even when the coverage decision is otherwise correct. Billing E0117 in place of either, regardless of unit count, results in an automatic LCD-level denial, not a simple claim adjustment.

There is no documentation fix for an E0117 claim submitted to traditional Medicare. The fix is confirming the dispensed device against the code before the order goes out.

Related HCPCS crutch and ambulatory aid codes

E0117 sits within a broader range of ambulatory aid codes. When the dispensed device does not match the E0117 descriptor, verify the correct code from the table below. The AAPC Codify HCPCS lookup provides full descriptors and crosswalk information for each.

For broader context on the E0114 billing guide and its documentation overlaps with E0117, reviewing adjacent code guides helps reduce coding errors across the range.

Two adjacent walker codes worth checking during code selection are E0158 and E0144, which cover walker accessories rather than crutches.

VA and Medicaid coverage for E0117

HCPCS Code E0117 is used across multiple payer types, but coverage rules differ meaningfully from Medicare.

Veterans Affairs (VA): Unlike traditional Medicare, the VA does reimburse E0117. The device is priced under the VA’s own Prosthetic and Sensory Aids Service (PSAS) fee schedule, at roughly $382 per unit as of 2026. That is a separate program from Medicare Part B, with its own coverage rules and pricing.

Coverage for specific devices is still determined at the Veterans Integrated Service Network (VISN) and facility level. Formulary status and documentation requirements may also differ from Medicare. Always verify E0117 coverage directly with the relevant VA facility before submitting a claim.

For patient compliance documentation best practices in VA contexts, maintain device-specific records per facility guidance.

Medicaid: State Medicaid programs vary considerably. Most states cover crutches as DME, and many use HCPCS Level II codes for billing, including E0117. Coverage criteria, prior authorization requirements, and reimbursement rates are state-specific.

Do not apply Medicare coverage rules to Medicaid claims without verifying the state’s DME benefit and applicable fee schedule. Some states require prior authorization for spring-assisted crutches specifically because of their higher cost relative to standard underarm crutches billed under E0114 or E0116.

Common billing errors and denial reasons for HCPCS Code E0117

Most E0117 denials fall into a small number of repeating patterns. Fixing these at the workflow level eliminates the majority of avoidable rejections.

• Billing E0117 to traditional Medicare at all: LCD L33733 denies E0117 as not reasonable and necessary. No SWO, face-to-face note, or delivery receipt changes that outcome. The fix is confirming the dispensed device before the order goes out, not documenting harder after the fact.
• SWO not received before delivery: For a covered code (E0110-E0116), the item was delivered before the supplier received a signed written order. This is one of the most straightforward denials and one of the hardest to appeal. The requirement is absolute: no SWO in hand before delivery means no compliant claim.
• Wrong code selection (E0114 vs E0116, or either miscoded as E0117): The device descriptor must match the code. Documentation and the delivery receipt must confirm the specific product dispensed. Billing E0117 for any dispensed device guarantees a denial, regardless of which underarm crutch was actually provided.
• Missing proof of delivery: A signed delivery receipt was not obtained or retained. Without it, post-payment audits result in automatic recoupment.
• Medical necessity not supported: For E0110-E0116, the clinical documentation does not establish why the patient needs a crutch. This concern does not apply to E0117, which is excluded from coverage regardless of the clinical picture.
• Bilateral billing error: Two units were dispensed, one per side, but only one E0116 unit was billed. Or a single E0114 pair code was substituted for two individual units. Because E0116 is an “each” code, bilateral dispensing requires two separate line items.

How practice management software reduces DME billing errors

DME billing for HCPCS Code E0117 involves multiple documentation checkpoints across intake, ordering, delivery, and submission. When these steps run through disconnected paper forms or manual processes, errors accumulate at each handoff. Practice management software consolidates these steps, keeping the SWO, clinical notes, and delivery confirmation in one linked record.

Pabau’s automated billing workflows flag incomplete documentation before a claim is submitted, reducing the cost of post-denial corrections. Staff across sports medicine, physical therapy, or DME supplier workflows can configure pre-submission alerts.

Those alerts flag an E0117 order before it reaches a doomed Medicare claim. The same checklists confirm the SWO, face-to-face encounter, device match, and delivery receipt are all on file. That catch-before-submission approach reduces avoidable denials compared to manual review.

For practices that combine clinical care with DME supply, the value compounds. EHR integration for billing connects the clinical record directly to the billing queue. The physician’s order and the supplier’s claim then reference the same documentation, rather than requiring manual re-entry.

Learn more about how medical practice management software supports DME billing workflows in a clinical setting.

Reduce DME billing denials with Pabau

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Conclusion

HCPCS Code E0117 denials are not a documentation problem. They are a coverage problem. LCD L33733 rules that medical necessity for the spring-assisted, articulating crutch has not been established. A claim billed under E0117 to traditional Medicare is denied as not reasonable and necessary, no matter how complete the file is.

CMS Policy Article A52459 confirms the same limit from the coverage-policy side. The Medicare-covered crutch code range stops at E0116, and E0117 sits outside it entirely.

Suppliers who need a Medicare-payable underarm crutch should confirm the dispensed device against the E0110-E0116 range before the order goes out.

Suppliers with a genuine E0117 need should look to the VA’s own Prosthetic and Sensory Aids Service fee schedule instead. Or they can turn to the patient’s state Medicaid program. Both are separate from Medicare Part B, and both can reimburse it under their own rules.

Pabau’s claims management software and paperless clinical workflows help DME suppliers and clinic billing teams catch a miscoded E0117 order. That keeps it from reaching a claims queue.

They also keep the SWO, face-to-face notes, and delivery documentation in order for the codes Medicare does pay. To see how Pabau handles DME documentation from order to submission, book a demo.

Continue your research

Need a complete DME billing workflow? HIPAA compliance for offices covers documentation retention and record-keeping requirements that apply to DME suppliers billing under Medicare Part B.

Managing billing across multiple clinical locations? Practice management software features covers the core capabilities DME-billing practices need to standardize pre-submission workflows.

Looking to reduce claim errors practice-wide? Capture forms software helps structure documentation intake so SWOs and delivery confirmations are captured in the right format every time.

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