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2025 HCPCS code S1002

Customized item, patient customized, not otherwise specified

This code should be reported in addition to the base code for the equipment being modified. It is not to be used for standard adjustments or accessories that are typically included with the item.

Modifiers may be applicable depending on the specific circumstances and payer guidelines.

Medical necessity must be established for the customization by demonstrating that the standard item does not meet the patient's needs and the modifications are essential for their medical condition.

In simple words: This code covers special modifications made to medical equipment specifically for your needs, beyond the standard options available.

Durable medical equipment that is uniquely constructed or modified for a specific patient due to their unique medical needs. This code is reported in addition to the code for the basic model of the same equipment.

Example 1: A patient requires a wheelchair with customized modifications due to their unusual body size or specific physical limitations. The S1002 code is used to bill for the modifications in addition to the code for the basic wheelchair., A child with a specific disability requires an adaptive stroller with specialized features. The S1002 code is used to bill for the adaptive components., An individual with an amputation needs a prosthetic limb with unique modifications to accommodate their residual limb and activity level.

Documentation should include the prescription for the customized item, details of the modifications, and a justification of medical necessity for the customization.

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