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Temporary Codes for Durable Medical Equipment Regional Carriers
HCPCS Code: K0
Short Description: Lwr ext prost functnl lvl 0
Long Description: Lower extremity prosthesis functional level 0 - does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance their quality of life or mobility.
HCPCS Code: K0001
Short Description: Standard wheelchair
Long Description: Standard wheelchair
HCPCS Code: K0002
Short Description: Stnd hemi (low seat) whlchr
Long Description: Standard hemi (low seat) wheelchair
HCPCS Code: K0003
Short Description: Lightweight wheelchair
Long Description: Lightweight wheelchair
HCPCS Code: K0004
Short Description: High strength ltwt whlchr
Long Description: High strength, lightweight wheelchair
HCPCS Code: K0005
Short Description: Ultralightweight wheelchair
Long Description: Ultralightweight wheelchair
HCPCS Code: K0006
Short Description: Heavy duty wheelchair
Long Description: Heavy duty wheelchair
HCPCS Code: K0007
Short Description: Extra heavy duty wheelchair
Long Description: Extra heavy duty wheelchair
HCPCS Code: K0008
Short Description: Cstm manual wheelchair/base
Long Description: Custom manual wheelchair/base
HCPCS Code: K0009
Short Description: Other manual wheelchair/base
Long Description: Other manual wheelchair/base
HCPCS Code: K0010
Short Description: Stnd wt frame power whlchr
Long Description: Standard - weight frame motorized/power wheelchair
HCPCS Code: K0011
Short Description: Stnd wt pwr whlchr w control
Long Description: Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking
HCPCS Code: K0012
Short Description: Ltwt portbl power whlchr
Long Description: Lightweight portable motorized/power wheelchair
HCPCS Code: K0013
Short Description: Custom power whlchr base
Long Description: Custom motorized/power wheelchair base
HCPCS Code: K0014
Short Description: Other power whlchr base
Long Description: Other motorized/power wheelchair base
HCPCS Code: K0015
Short Description: Detach non-adj ht armrst rep
Long Description: Detachable, non-adjustable height armrest, replacement only, each
HCPCS Code: K0017
Short Description: Detach adjust armrest base
Long Description: Detachable, adjustable height armrest, base, replacement only, each
HCPCS Code: K0018
Short Description: Detach adjust armrst upper
Long Description: Detachable, adjustable height armrest, upper portion, replacement only, each
HCPCS Code: K0019
Short Description: Arm pad repl, each
Long Description: Arm pad, replacement only, each
HCPCS Code: K0020
Short Description: Fixed adjust armrest pair
Long Description: Fixed, adjustable height armrest, pair
HCPCS Code: K0037
Short Description: Hi mount flip-up ftrest repl
Long Description: High mount flip-up footrest, replacement only, each
HCPCS Code: K0038
Short Description: Leg strap each
Long Description: Leg strap, each
HCPCS Code: K0039
Short Description: Leg strap h style each
Long Description: Leg strap, h style, each
HCPCS Code: K0040
Short Description: Adjustable angle footplate
Long Description: Adjustable angle footplate, each
HCPCS Code: K0041
Short Description: Large size footplate each
Long Description: Large size footplate, each
HCPCS Code: K0042
Short Description: Standard size ftplate rep ea
Long Description: Standard size footplate, replacement only, each
HCPCS Code: K0043
Short Description: Ftrst lowr exten tube rep ea
Long Description: Footrest, lower extension tube, replacement only, each
HCPCS Code: K0044
Short Description: Ftrst upr hanger brac rep ea
Long Description: Footrest, upper hanger bracket, replacement only, each
HCPCS Code: K0045
Short Description: Ftrst compl assembly repl ea
Long Description: Footrest, complete assembly, replacement only, each
HCPCS Code: K0046
Short Description: Elev lgrst lwr exten repl ea
Long Description: Elevating legrest, lower extension tube, replacement only, each
HCPCS Code: K0047
Short Description: Elev legrst upr hangr rep ea
Long Description: Elevating legrest, upper hanger bracket, replacement only, each
HCPCS Code: K0050
Short Description: Ratchet assembly replacement
Long Description: Ratchet assembly, replacement only
HCPCS Code: K0051
Short Description: Cam rel asm ft/legrst rep ea
Long Description: Cam release assembly, footrest or legrest, replacement only, each
HCPCS Code: K0052
Short Description: Swingaway detach ftrest repl
Long Description: Swingaway, detachable footrests, replacement only, each
HCPCS Code: K0053
Short Description: Elevate footrest articulate
Long Description: Elevating footrests, articulating (telescoping), each
HCPCS Code: K0056
Short Description: Seat ht <17 or >=21 ltwt wc
Long Description: Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair
HCPCS Code: K0065
Short Description: Spoke protectors
Long Description: Spoke protectors, each
HCPCS Code: K0069
Short Description: Rr whl compl sol tire rep ea
Long Description: Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each
HCPCS Code: K0070
Short Description: Rr whl compl pne tire rep ea
Long Description: Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each
HCPCS Code: K0071
Short Description: Fr cstr comp pne tire rep ea
Long Description: Front caster assembly, complete, with pneumatic tire, replacement only, each
HCPCS Code: K0072
Short Description: Fr cstr semi-pne tire rep ea
Long Description: Front caster assembly, complete, with semi-pneumatic tire, replacement only, each
HCPCS Code: K0073
Short Description: Caster pin lock each
Long Description: Caster pin lock, each
HCPCS Code: K0077
Short Description: Fr cstr asmb sol tire rep ea
Long Description: Front caster assembly, complete, with solid tire, replacement only, each
HCPCS Code: K0098
Short Description: Drive belt for pwc, repl
Long Description: Drive belt for power wheelchair, replacement only
HCPCS Code: K0105
Short Description: Iv hanger
Long Description: Iv hanger, each
HCPCS Code: K0108
Short Description: W/c component-accessory nos
Long Description: Wheelchair component or accessory, not otherwise specified
HCPCS Code: K0195
Short Description: Elevating whlchair leg rests
Long Description: Elevating leg rests, pair (for use with capped rental wheelchair base)
HCPCS Code: K0455
Short Description: Pump uninterrupted infusion
Long Description: Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)
HCPCS Code: K0462
Short Description: Temporary replacement eqpmnt
Long Description: Temporary replacement for patient owned equipment being repaired, any type
HCPCS Code: K0552
Short Description: Sup/ext non-ins inf pump syr
Long Description: Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each
HCPCS Code: K0553
Short Description: Ther cgm supply allowance
Long Description: Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
HCPCS Code: K0554
Short Description: Ther cgm receiver/monitor
Long Description: Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system
HCPCS Code: K0601
Short Description: Repl batt silver oxide 1.5 v
Long Description: Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each
HCPCS Code: K0602
Short Description: Repl batt silver oxide 3 v
Long Description: Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each
HCPCS Code: K0603
Short Description: Repl batt alkaline 1.5 v
Long Description: Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each
HCPCS Code: K0604
Short Description: Repl batt lithium 3.6 v
Long Description: Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each
HCPCS Code: K0605
Short Description: Repl batt lithium 4.5 v
Long Description: Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each
HCPCS Code: K0606
Short Description: Aed garment w elec analysis
Long Description: Automatic external defibrillator, with integrated electrocardiogram analysis, garment type
HCPCS Code: K0607
Short Description: Repl batt for aed
Long Description: Replacement battery for automated external defibrillator, garment type only, each
HCPCS Code: K0608
Short Description: Repl garment for aed
Long Description: Replacement garment for use with automated external defibrillator, each
HCPCS Code: K0609
Short Description: Repl electrode for aed
Long Description: Replacement electrodes for use with automated external defibrillator, garment type only, each
HCPCS Code: K0669
Short Description: Seat/back cus no dmepdac ver
Long Description: Wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from dme pdac
HCPCS Code: K0672
Short Description: Removable soft interface le
Long Description: Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each
HCPCS Code: K0730
Short Description: Ctrl dose inh drug deliv sys
Long Description: Controlled dose inhalation drug delivery system
HCPCS Code: K0733
Short Description: 12-24hr sealed lead acid
Long Description: Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)
HCPCS Code: K0738
Short Description: Portable gas oxygen system
Long Description: Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing
HCPCS Code: K0739
Short Description: Repair/svc dme non-oxygen eq
Long Description: Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes
HCPCS Code: K0740
Short Description: Repair/svc oxygen equipment
Long Description: Repair or nonroutine service for oxygen equipment requiring the skill of a technician, labor component, per 15 minutes
HCPCS Code: K0743
Short Description: Portable home suction pump
Long Description: Suction pump, home model, portable, for use on wounds
HCPCS Code: K0744
Short Description: Absorp drg <= 16 suc pump
Long Description: Absorptive wound dressing for use with suction pump, home model, portable, pad size 16 square inches or less
HCPCS Code: K0745
Short Description: Absorp drg >16<=48 suc pump
Long Description: Absorptive wound dressing for use with suction pump, home model, portable, pad size more than 16 square inches but less than or equal to 48 square inches
HCPCS Code: K0746
Short Description: Absorp drg >48 suc pump
Long Description: Absorptive wound dressing for use with suction pump, home model, portable, pad size greater than 48 square inches
HCPCS Code: K0800
Short Description: Pov group 1 std up to 300lbs
Long Description: Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds
HCPCS Code: K0801
Short Description: Pov group 1 hd 301-450 lbs
Long Description: Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds
HCPCS Code: K0802
Short Description: Pov group 1 vhd 451-600 lbs
Long Description: Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds
HCPCS Code: K0806
Short Description: Pov group 2 std up to 300lbs
Long Description: Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds
HCPCS Code: K0807
Short Description: Pov group 2 hd 301-450 lbs
Long Description: Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds
HCPCS Code: K0808
Short Description: Pov group 2 vhd 451-600 lbs
Long Description: Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds
HCPCS Code: K0812
Short Description: Power operated vehicle noc
Long Description: Power operated vehicle, not otherwise classified
HCPCS Code: K0813
Short Description: Pwc gp 1 std port seat/back
Long Description: Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds
HCPCS Code: K0814
Short Description: Pwc gp 1 std port cap chair
Long Description: Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds
HCPCS Code: K0815
Short Description: Pwc gp 1 std seat/back
Long Description: Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds
HCPCS Code: K0816
Short Description: Pwc gp 1 std cap chair
Long Description: Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds
HCPCS Code: K0820
Short Description: Pwc gp 2 std port seat/back
Long Description: Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds
HCPCS Code: K0821
Short Description: Pwc gp 2 std port cap chair
Long Description: Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds
HCPCS Code: K0822
Short Description: Pwc gp 2 std seat/back
Long Description: Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
HCPCS Code: K0823
Short Description: Pwc gp 2 std cap chair
Long Description: Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds
HCPCS Code: K0824
Short Description: Pwc gp 2 hd seat/back
Long Description: Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
HCPCS Code: K0825
Short Description: Pwc gp 2 hd cap chair
Long Description: Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds
HCPCS Code: K0826
Short Description: Pwc gp 2 vhd seat/back
Long Description: Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
HCPCS Code: K0827
Short Description: Pwc gp vhd cap chair
Long Description: Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds
HCPCS Code: K0828
Short Description: Pwc gp 2 xtra hd seat/back
Long Description: Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more
HCPCS Code: K0829
Short Description: Pwc gp 2 xtra hd cap chair
Long Description: Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more
HCPCS Code: K0830
Short Description: Pwc gp2 std seat elevate s/b
Long Description: Power wheelchair, group 2 standard, seat elevator, sling/solid seat/back, patient weight capacity up to and including 300 pounds
HCPCS Code: K0831
Short Description: Pwc gp2 std seat elevate cap
Long Description: Power wheelchair, group 2 standard, seat elevator, captains chair, patient weight capacity up to and including 300 pounds
HCPCS Code: K0835
Short Description: Pwc gp2 std sing pow opt s/b
Long Description: Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
HCPCS Code: K0836
Short Description: Pwc gp2 std sing pow opt cap
Long Description: Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
HCPCS Code: K0837
Short Description: Pwc gp 2 hd sing pow opt s/b
Long Description: Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
HCPCS Code: K0838
Short Description: Pwc gp 2 hd sing pow opt cap
Long Description: Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds
HCPCS Code: K0839
Short Description: Pwc gp2 vhd sing pow opt s/b
Long Description: Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
HCPCS Code: K0840
Short Description: Pwc gp2 xhd sing pow opt s/b
Long Description: Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more
HCPCS Code: K0841
Short Description: Pwc gp2 std mult pow opt s/b
Long Description: Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
HCPCS Code: K0842
Short Description: Pwc gp2 std mult pow opt cap
Long Description: Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds
HCPCS Code: K0843
Short Description: Pwc gp2 hd mult pow opt s/b
Long Description: Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
HCPCS Code: K0848
Short Description: Pwc gp 3 std seat/back
Long Description: Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
HCPCS Code: K0849
Short Description: Pwc gp 3 std cap chair
Long Description: Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds
HCPCS Code: K0850
Short Description: Pwc gp 3 hd seat/back
Long Description: Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
HCPCS Code: K0851
Short Description: Pwc gp 3 hd cap chair
Long Description: Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds
HCPCS Code: K0852
Short Description: Pwc gp 3 vhd seat/back
Long Description: Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
HCPCS Code: K0853
Short Description: Pwc gp 3 vhd cap chair
Long Description: Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds
HCPCS Code: K0854
Short Description: Pwc gp 3 xhd seat/back
Long Description: Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more
HCPCS Code: K0855
Short Description: Pwc gp 3 xhd cap chair
Long Description: Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more
HCPCS Code: K0856
Short Description: Pwc gp3 std sing pow opt s/b
Long Description: Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
HCPCS Code: K0857
Short Description: Pwc gp3 std sing pow opt cap
Long Description: Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
HCPCS Code: K0858
Short Description: Pwc gp3 hd sing pow opt s/b
Long Description: Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds
HCPCS Code: K0859
Short Description: Pwc gp3 hd sing pow opt cap
Long Description: Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds
HCPCS Code: K0860
Short Description: Pwc gp3 vhd sing pow opt s/b
Long Description: Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
HCPCS Code: K0861
Short Description: Pwc gp3 std mult pow opt s/b
Long Description: Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
HCPCS Code: K0862
Short Description: Pwc gp3 hd mult pow opt s/b
Long Description: Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
HCPCS Code: K0863
Short Description: Pwc gp3 vhd mult pow opt s/b
Long Description: Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
HCPCS Code: K0864
Short Description: Pwc gp3 xhd mult pow opt s/b
Long Description: Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more
HCPCS Code: K0868
Short Description: Pwc gp 4 std seat/back
Long Description: Power wheelchair, group 4 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
HCPCS Code: K0869
Short Description: Pwc gp 4 std cap chair
Long Description: Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds
HCPCS Code: K0870
Short Description: Pwc gp 4 hd seat/back
Long Description: Power wheelchair, group 4 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
HCPCS Code: K0871
Short Description: Pwc gp 4 vhd seat/back
Long Description: Power wheelchair, group 4 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
HCPCS Code: K0877
Short Description: Pwc gp4 std sing pow opt s/b
Long Description: Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
HCPCS Code: K0878
Short Description: Pwc gp4 std sing pow opt cap
Long Description: Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
HCPCS Code: K0879
Short Description: Pwc gp4 hd sing pow opt s/b
Long Description: Power wheelchair, group 4 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
HCPCS Code: K0880
Short Description: Pwc gp4 vhd sing pow opt s/b
Long Description: Power wheelchair, group 4 very heavy duty, single power option, sling/solid seat/back, patient weight 451 to 600 pounds
HCPCS Code: K0884
Short Description: Pwc gp4 std mult pow opt s/b
Long Description: Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
HCPCS Code: K0885
Short Description: Pwc gp4 std mult pow opt cap
Long Description: Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds
HCPCS Code: K0886
Short Description: Pwc gp4 hd mult pow s/b
Long Description: Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
HCPCS Code: K0890
Short Description: Pwc gp5 ped sing pow opt s/b
Long Description: Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
HCPCS Code: K0891
Short Description: Pwc gp5 ped mult pow opt s/b
Long Description: Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
HCPCS Code: K0898
Short Description: Power wheelchair noc
Long Description: Power wheelchair, not otherwise classified
HCPCS Code: K0899
Short Description: Pow mobil dev no dmepdac
Long Description: Power mobility device, not coded by dme pdac or does not meet criteria
HCPCS Code: K0900
Short Description: Cstm dme other than wheelchr
Long Description: Customized durable medical equipment, other than wheelchair
HCPCS Code: K0901
Short Description: Ko single upright pre ots
Long Description: Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
HCPCS Code: K0902
Short Description: Ko double upright pre ots
Long Description: Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
HCPCS Code: K1
Short Description: Lwr ext prost functnl lvl 1
Long Description: Lower extremity prosthesis functional level 1 - has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. typical of the limited and unlimited household ambulator.
HCPCS Code: K2
Short Description: Lwr ext prost functnl lvl 2
Long Description: Lower extremity prosthesis functional level 2 - has the ability or potential for ambulation with the ability to traverse low level environmental barriers such as curbs, stairs or uneven surfaces. typical of the limited community ambulator.
HCPCS Code: K3
Short Description: Lwr ext prost functnl lvl 3
Long Description: Lower extremity prosthesis functional level 3 - has the ability or potential for ambulation with variable cadence. typical of the community ambulator who has the ability to transverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion.
HCPCS Code: K4
Short Description: Lwr ext prost functnl lvl 4
Long Description: Lower extremity prosthesis functional level 4 - has the ability or potential for prosthetic ambulation that exceeds the basic ambulation skills, exhibiting high impact, stress, or energy levels, typical of the prosthetic demands of the child, active adult, or athlete.
HCPCS Code: KA
Short Description: Wheelchair add-on option/acc
Long Description: Add on option/accessory for wheelchair
HCPCS Code: KB
Short Description: >4 modifiers on claim
Long Description: Beneficiary requested upgrade for abn, more than 4 modifiers identified on claim
HCPCS Code: KC
Short Description: Repl special pwr wc intrface
Long Description: Replacement of special power wheelchair interface
HCPCS Code: KD
Short Description: Drug/biological dme infused
Long Description: Drug or biological infused through dme
HCPCS Code: KE
Short Description: Bid under round 1 dmepos cb
Long Description: Bid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipment
HCPCS Code: KF
Short Description: Fda class iii device
Long Description: Item designated by fda as class iii device
HCPCS Code: KG
Short Description: Dmepos comp bid prgm no 1
Long Description: Dmepos item subject to dmepos competitive bidding program number 1
HCPCS Code: KH
Short Description: Dmepos ini clm, pur/1 mo rnt
Long Description: Dmepos item, initial claim, purchase or first month rental
HCPCS Code: KI
Short Description: Dmepos 2nd or 3rd mo rental
Long Description: Dmepos item, second or third month rental
HCPCS Code: KJ
Short Description: Dmepos pen pmp or 4-15mo rnt
Long Description: Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen
HCPCS Code: KK
Short Description: Dmepos comp bid prgm no 2
Long Description: Dmepos item subject to dmepos competitive bidding program number 2
HCPCS Code: KL
Short Description: Dmepos mailorder comp bid
Long Description: Dmepos item delivered via mail
HCPCS Code: KM
Short Description: Rplc facial prosth new imp
Long Description: Replacement of facial prosthesis including new impression/moulage
HCPCS Code: KN
Short Description: Rplc facial prosth old mod
Long Description: Replacement of facial prosthesis using previous master model
HCPCS Code: KO
Short Description: Single drug unit dose form
Long Description: Single drug unit dose formulation
HCPCS Code: KP
Short Description: First drug of multi drug u d
Long Description: First drug of a multiple drug unit dose formulation
HCPCS Code: KQ
Short Description: 2nd/subsqnt drg multi drg ud
Long Description: Second or subsequent drug of a multiple drug unit dose formulation
HCPCS Code: KR
Short Description: Rental item partial month
Long Description: Rental item, billing for partial month
HCPCS Code: KS
Short Description: Glucose monitor supply
Long Description: Glucose monitor supply for diabetic beneficiary not treated with insulin
HCPCS Code: KT
Short Description: Item from noncontract supply
Long Description: Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item
HCPCS Code: KU
Short Description: Dmepos comp bid prgm no 3
Long Description: Dmepos item subject to dmepos competitive bidding program number 3
HCPCS Code: KV
Short Description: Dmepos item, profession serv
Long Description: Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service
HCPCS Code: KW
Short Description: Dmepos comp bid prgm no 4
Long Description: Dmepos item subject to dmepos competitive bidding program number 4
HCPCS Code: KX
Short Description: Documentation on file
Long Description: Requirements specified in the medical policy have been met
HCPCS Code: KY
Short Description: Dmepos comp bid prgm no 5
Long Description: Dmepos item subject to dmepos competitive bidding program number 5
HCPCS Code: KZ
Short Description: New cov not implement by m+c
Long Description: New coverage not implemented by managed care