List of HCPCS codes for: Temporary Codes for Durable Medical Equipment Regional Carriers (K-codes) - Group K0

HCPCS Code	Short Description	Long Description
K0	Lwr ext prost functnl lvl 0	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.
K0001	Standard wheelchair	Standard wheelchair
K0002	Stnd hemi (low seat) whlchr	Standard hemi (low seat) wheelchair
K0003	Lightweight wheelchair	Lightweight wheelchair
K0004	High strength ltwt whlchr	High strength, lightweight wheelchair
K0005	Ultralightweight wheelchair	Ultralightweight wheelchair
K0006	Heavy duty wheelchair	Heavy duty wheelchair
K0007	Extra heavy duty wheelchair	Extra heavy duty wheelchair
K0008	Cstm manual wheelchair/base	Custom manual wheelchair/base
K0009	Other manual wheelchair/base	Other manual wheelchair/base
K0010	Stnd wt frame power whlchr	Standard - weight frame motorized/power wheelchair
K0011	Stnd wt pwr whlchr w control	Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking
K0012	Ltwt portbl power whlchr	Lightweight portable motorized/power wheelchair
K0013	Custom power whlchr base	Custom motorized/power wheelchair base
K0014	Other power whlchr base	Other motorized/power wheelchair base
K0015	Detach non-adj ht armrst rep	Detachable, non-adjustable height armrest, replacement only, each
K0017	Detach adjust armrest base	Detachable, adjustable height armrest, base, replacement only, each
K0018	Detach adjust armrst upper	Detachable, adjustable height armrest, upper portion, replacement only, each
K0019	Arm pad repl, each	Arm pad, replacement only, each
K0020	Fixed adjust armrest pair	Fixed, adjustable height armrest, pair
K0037	Hi mount flip-up footrest ea	High mount flip-up footrest, each
K0038	Leg strap each	Leg strap, each
K0039	Leg strap h style each	Leg strap, h style, each
K0040	Adjustable angle footplate	Adjustable angle footplate, each
K0041	Large size footplate each	Large size footplate, each
K0042	Standard size ftplate rep ea	Standard size footplate, replacement only, each
K0043	Ftrst lowr exten tube rep ea	Footrest, lower extension tube, replacement only, each
K0044	Ftrst upr hanger brac rep ea	Footrest, upper hanger bracket, replacement only, each
K0045	Ftrst compl assembly repl ea	Footrest, complete assembly, replacement only, each
K0046	Elev lgrst lwr exten repl ea	Elevating legrest, lower extension tube, replacement only, each
K0047	Elev legrst upr hangr rep ea	Elevating legrest, upper hanger bracket, replacement only, each
K0050	Ratchet assembly replacement	Ratchet assembly, replacement only
K0051	Cam rel asm ft/legrst rep ea	Cam release assembly, footrest or legrest, replacement only, each
K0052	Swingaway detach ftrest repl	Swingaway, detachable footrests, replacement only, each
K0053	Elevate footrest articulate	Elevating footrests, articulating (telescoping), each
K0056	Seat ht <17 or >=21 ltwt wc	Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair
K0065	Spoke protectors	Spoke protectors, each
K0069	Rr whl compl sol tire rep ea	Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each
K0070	Rr whl compl pne tire rep ea	Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each
K0071	Fr cstr comp pne tire rep ea	Front caster assembly, complete, with pneumatic tire, replacement only, each
K0072	Fr cstr semi-pne tire rep ea	Front caster assembly, complete, with semi-pneumatic tire, replacement only, each
K0073	Caster pin lock each	Caster pin lock, each
K0077	Fr cstr asmb sol tire rep ea	Front caster assembly, complete, with solid tire, replacement only, each
K0098	Drive belt for pwc, repl	Drive belt for power wheelchair, replacement only
K0105	Iv hanger	Iv hanger, each
K0108	W/c component-accessory nos	Wheelchair component or accessory, not otherwise specified
K0195	Elevating whlchair leg rests	Elevating leg rests, pair (for use with capped rental wheelchair base)
K0455	Pump uninterrupted infusion	Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)
K0462	Temporary replacement eqpmnt	Temporary replacement for patient owned equipment being repaired, any type
K0552	Sup/ext non-ins inf pump syr	Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each
K0553	Ther cgm supply allowance	Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
K0554	Ther cgm receiver/monitor	Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system
K0601	Repl batt silver oxide 1.5 v	Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each
K0602	Repl batt silver oxide 3 v	Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each
K0603	Repl batt alkaline 1.5 v	Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each
K0604	Repl batt lithium 3.6 v	Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each
K0605	Repl batt lithium 4.5 v	Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each
K0606	Aed garment w elec analysis	Automatic external defibrillator, with integrated electrocardiogram analysis, garment type
K0607	Repl batt for aed	Replacement battery for automated external defibrillator, garment type only, each
K0608	Repl garment for aed	Replacement garment for use with automated external defibrillator, each
K0609	Repl electrode for aed	Replacement electrodes for use with automated external defibrillator, garment type only, each
K0669	Seat/back cus no dmepdac ver	Wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from dme pdac
K0672	Removable soft interface le	Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each
K0730	Ctrl dose inh drug deliv sys	Controlled dose inhalation drug delivery system
K0733	12-24hr sealed lead acid	Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)
K0738	Portable gas oxygen system	Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing
K0739	Repair/svc dme non-oxygen eq	Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes
K0740	Repair/svc oxygen equipment	Repair or nonroutine service for oxygen equipment requiring the skill of a technician, labor component, per 15 minutes
K0743	Portable home suction pump	Suction pump, home model, portable, for use on wounds
K0744	Absorp drg <= 16 suc pump	Absorptive wound dressing for use with suction pump, home model, portable, pad size 16 square inches or less
K0745	Absorp drg >16<=48 suc pump	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
K0746	Absorp drg >48 suc pump	Absorptive wound dressing for use with suction pump, home model, portable, pad size greater than 48 square inches
K0800	Pov group 1 std up to 300lbs	Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds
K0801	Pov group 1 hd 301-450 lbs	Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds
K0802	Pov group 1 vhd 451-600 lbs	Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds
K0806	Pov group 2 std up to 300lbs	Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds
K0807	Pov group 2 hd 301-450 lbs	Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds
K0808	Pov group 2 vhd 451-600 lbs	Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds
K0812	Power operated vehicle noc	Power operated vehicle, not otherwise classified
K0813	Pwc gp 1 std port seat/back	Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds
K0814	Pwc gp 1 std port cap chair	Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds
K0815	Pwc gp 1 std seat/back	Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds
K0816	Pwc gp 1 std cap chair	Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds
K0820	Pwc gp 2 std port seat/back	Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds
K0821	Pwc gp 2 std port cap chair	Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds
K0822	Pwc gp 2 std seat/back	Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
K0823	Pwc gp 2 std cap chair	Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds
K0824	Pwc gp 2 hd seat/back	Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
K0825	Pwc gp 2 hd cap chair	Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds
K0826	Pwc gp 2 vhd seat/back	Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
K0827	Pwc gp vhd cap chair	Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds
K0828	Pwc gp 2 xtra hd seat/back	Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more
K0829	Pwc gp 2 xtra hd cap chair	Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more
K0830	Pwc gp2 std seat elevate s/b	Power wheelchair, group 2 standard, seat elevator, sling/solid seat/back, patient weight capacity up to and including 300 pounds
K0831	Pwc gp2 std seat elevate cap	Power wheelchair, group 2 standard, seat elevator, captains chair, patient weight capacity up to and including 300 pounds
K0835	Pwc gp2 std sing pow opt s/b	Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
K0836	Pwc gp2 std sing pow opt cap	Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
K0837	Pwc gp 2 hd sing pow opt s/b	Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
K0838	Pwc gp 2 hd sing pow opt cap	Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds
K0839	Pwc gp2 vhd sing pow opt s/b	Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
K0840	Pwc gp2 xhd sing pow opt s/b	Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more
K0841	Pwc gp2 std mult pow opt s/b	Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
K0842	Pwc gp2 std mult pow opt cap	Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds
K0843	Pwc gp2 hd mult pow opt s/b	Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
K0848	Pwc gp 3 std seat/back	Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
K0849	Pwc gp 3 std cap chair	Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds
K0850	Pwc gp 3 hd seat/back	Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
K0851	Pwc gp 3 hd cap chair	Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds
K0852	Pwc gp 3 vhd seat/back	Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
K0853	Pwc gp 3 vhd cap chair	Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds
K0854	Pwc gp 3 xhd seat/back	Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more
K0855	Pwc gp 3 xhd cap chair	Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more
K0856	Pwc gp3 std sing pow opt s/b	Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
K0857	Pwc gp3 std sing pow opt cap	Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
K0858	Pwc gp3 hd sing pow opt s/b	Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds
K0859	Pwc gp3 hd sing pow opt cap	Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds
K0860	Pwc gp3 vhd sing pow opt s/b	Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
K0861	Pwc gp3 std mult pow opt s/b	Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
K0862	Pwc gp3 hd mult pow opt s/b	Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
K0863	Pwc gp3 vhd mult pow opt s/b	Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
K0864	Pwc gp3 xhd mult pow opt s/b	Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more
K0868	Pwc gp 4 std seat/back	Power wheelchair, group 4 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
K0869	Pwc gp 4 std cap chair	Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds
K0870	Pwc gp 4 hd seat/back	Power wheelchair, group 4 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
K0871	Pwc gp 4 vhd seat/back	Power wheelchair, group 4 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
K0877	Pwc gp4 std sing pow opt s/b	Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
K0878	Pwc gp4 std sing pow opt cap	Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
K0879	Pwc gp4 hd sing pow opt s/b	Power wheelchair, group 4 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
K0880	Pwc gp4 vhd sing pow opt s/b	Power wheelchair, group 4 very heavy duty, single power option, sling/solid seat/back, patient weight 451 to 600 pounds
K0884	Pwc gp4 std mult pow opt s/b	Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
K0885	Pwc gp4 std mult pow opt cap	Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds
K0886	Pwc gp4 hd mult pow s/b	Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
K0890	Pwc gp5 ped sing pow opt s/b	Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
K0891	Pwc gp5 ped mult pow opt s/b	Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
K0898	Power wheelchair noc	Power wheelchair, not otherwise classified
K0899	Pow mobil dev no dmepdac	Power mobility device, not coded by dme pdac or does not meet criteria
K0900	Cstm dme other than wheelchr	Customized durable medical equipment, other than wheelchair
K0901	Ko single upright pre ots	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
K0902	Ko double upright pre ots	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
K0903	Mult den insert dir carv/cam	For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each