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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