K0000–K9999: Durable Medical Equipment for Medicare Administrative Contractors

HCPC SEQNUM RECID LONG DESCRIPTION SHORT DESCRIPTION
K0001 0010 3 Standard wheelchair Standard wheelchair
K0002 0010 3 Standard hemi (low seat) wheelchair Stnd hemi (low seat) whlchr
K0003 0010 3 Lightweight wheelchair Lightweight wheelchair
K0004 0010 3 High strength, lightweight wheelchair High strength ltwt whlchr
K0005 0010 3 Ultralightweight wheelchair Ultralightweight wheelchair
K0006 0010 3 Heavy duty wheelchair Heavy duty wheelchair
K0007 0010 3 Extra heavy duty wheelchair Extra heavy duty wheelchair
K0008 0010 3 Custom manual wheelchair/base Cstm manual wheelchair/base
K0009 0010 3 Other manual wheelchair/base Other manual wheelchair/base
K0010 0010 3 Standard - weight frame motorized/power wheelchair Stnd wt frame power whlchr
K0011 0010 3 Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking Stnd wt pwr whlchr w control
K0012 0010 3 Lightweight portable motorized/power wheelchair Ltwt portbl power whlchr
K0013 0010 3 Custom motorized/power wheelchair base Custom power whlchr base
K0014 0010 3 Other motorized/power wheelchair base Other power whlchr base
K0015 0010 3 Detachable, non-adjustable height armrest, replacement only, each Detach non-adj ht armrst rep
K0017 0010 3 Detachable, adjustable height armrest, base, replacement only, each Detach adjust armrest base
K0018 0010 3 Detachable, adjustable height armrest, upper portion, replacement only, each Detach adjust armrst upper
K0019 0010 3 Arm pad, replacement only, each Arm pad repl, each
K0020 0010 3 Fixed, adjustable height armrest, pair Fixed adjust armrest pair
K0037 0010 3 High mount flip-up footrest, each Hi mount flip-up footrest ea
K0038 0010 3 Leg strap, each Leg strap each
K0039 0010 3 Leg strap, h style, each Leg strap h style each
K0040 0010 3 Adjustable angle footplate, each Adjustable angle footplate
K0041 0010 3 Large size footplate, each Large size footplate each
K0042 0010 3 Standard size footplate, replacement only, each Standard size ftplate rep ea
K0043 0010 3 Footrest, lower extension tube, replacement only, each Ftrst lowr exten tube rep ea
K0044 0010 3 Footrest, upper hanger bracket, replacement only, each Ftrst upr hanger brac rep ea
K0045 0010 3 Footrest, complete assembly, replacement only, each Ftrst compl assembly repl ea
K0046 0010 3 Elevating legrest, lower extension tube, replacement only, each Elev lgrst lwr exten repl ea
K0047 0010 3 Elevating legrest, upper hanger bracket, replacement only, each Elev legrst upr hangr rep ea
K0050 0010 3 Ratchet assembly, replacement only Ratchet assembly replacement
K0051 0010 3 Cam release assembly, footrest or legrest, replacement only, each Cam rel asm ft/legrst rep ea
K0052 0010 3 Swingaway, detachable footrests, replacement only, each Swingaway detach ftrest repl
K0053 0010 3 Elevating footrests, articulating (telescoping), each Elevate footrest articulate
K0056 0010 3 Seat height less than 17” or equal to or greater than 21” for a high strength, lightweight, or ultralightweight wheelchair Seat ht <17 or >=21 ltwt wc
K0065 0010 3 Spoke protectors, each Spoke protectors
K0069 0010 3 Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each Rr whl compl sol tire rep ea
K0070 0010 3 Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each Rr whl compl pne tire rep ea
K0071 0010 3 Front caster assembly, complete, with pneumatic tire, replacement only, each Fr cstr comp pne tire rep ea
K0072 0010 3 Front caster assembly, complete, with semi-pneumatic tire, replacement only, each Fr cstr semi-pne tire rep ea
K0073 0010 3 Caster pin lock, each Caster pin lock each
K0077 0010 3 Front caster assembly, complete, with solid tire, replacement only, each Fr cstr asmb sol tire rep ea
K0098 0010 3 Drive belt for power wheelchair, replacement only Drive belt for pwc, repl
K0105 0010 3 Iv hanger, each Iv hanger
K0108 0010 3 Wheelchair component or accessory, not otherwise specified W/c component-accessory nos
K0195 0010 3 Elevating leg rests, pair (for use with capped rental wheelchair base) Elevating whlchair leg rests
K0455 0010 3 Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol) Pump uninterrupted infusion
K0462 0010 3 Temporary replacement for patient owned equipment being repaired, any type Temporary replacement eqpmnt
K0552 0010 3 Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each Sup/ext non-ins inf pump syr
K0553 0010 3 Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service Ther cgm supply allowance
K0554 0010 3 Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system Ther cgm receiver/monitor
K0601 0010 3 Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each Repl batt silver oxide 1.5 v
K0602 0010 3 Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each Repl batt silver oxide 3 v
K0603 0010 3 Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each Repl batt alkaline 1.5 v
K0604 0010 3 Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each Repl batt lithium 3.6 v
K0605 0010 3 Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each Repl batt lithium 4.5 v
K0606 0010 3 Automatic external defibrillator, with integrated electrocardiogram analysis, garment type Aed garment w elec analysis
K0607 0010 3 Replacement battery for automated external defibrillator, garment type only, each Repl batt for aed
K0608 0010 3 Replacement garment for use with automated external defibrillator, each Repl garment for aed
K0609 0010 3 Replacement electrodes for use with automated external defibrillator, garment type only, each Repl electrode for aed
K0669 0010 3 Wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from dme pdac Seat/back cus no dmepdac ver
K0672 0010 3 Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each Removable soft interface le
K0730 0010 3 Controlled dose inhalation drug delivery system Ctrl dose inh drug deliv sys
K0733 0010 3 Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) 12-24hr sealed lead acid
K0738 0010 3 Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing Portable gas oxygen system
K0739 0010 3 Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes Repair/svc dme non-oxygen eq
K0740 0010 3 Repair or nonroutine service for oxygen equipment requiring the skill of a technician, labor component, per 15 minutes Repair/svc oxygen equipment
K0743 0010 3 Suction pump, home model, portable, for use on wounds Portable home suction pump
K0744 0010 3 Absorptive wound dressing for use with suction pump, home model, portable, pad size 16 square inches or less Absorp drg <= 16 suc pump
K0745 0010 3 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 Absorp drg >16<=48 suc pump
K0746 0010 3 Absorptive wound dressing for use with suction pump, home model, portable, pad size greater than 48 square inches Absorp drg >48 suc pump
K0800 0010 3 Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds Pov group 1 std up to 300lbs
K0801 0010 3 Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds Pov group 1 hd 301-450 lbs
K0802 0010 3 Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds Pov group 1 vhd 451-600 lbs
K0806 0010 3 Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds Pov group 2 std up to 300lbs
K0807 0010 3 Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds Pov group 2 hd 301-450 lbs
K0808 0010 3 Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds Pov group 2 vhd 451-600 lbs
K0812 0010 3 Power operated vehicle, not otherwise classified Power operated vehicle noc
K0813 0010 3 Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds Pwc gp 1 std port seat/back
K0814 0010 3 Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds Pwc gp 1 std port cap chair
K0815 0010 3 Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds Pwc gp 1 std seat/back
K0816 0010 3 Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds Pwc gp 1 std cap chair
K0820 0010 3 Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds Pwc gp 2 std port seat/back
K0821 0010 3 Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds Pwc gp 2 std port cap chair
K0822 0010 3 Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds Pwc gp 2 std seat/back
K0823 0010 3 Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds Pwc gp 2 std cap chair
K0824 0010 3 Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds Pwc gp 2 hd seat/back
K0825 0010 3 Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds Pwc gp 2 hd cap chair
K0826 0010 3 Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds Pwc gp 2 vhd seat/back
K0827 0010 3 Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds Pwc gp vhd cap chair
K0828 0010 3 Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more Pwc gp 2 xtra hd seat/back
K0829 0010 3 Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more Pwc gp 2 xtra hd cap chair
K0830 0010 3 Power wheelchair, group 2 standard, seat elevator, sling/solid seat/back, patient weight capacity up to and including 300 pounds Pwc gp2 std seat elevate s/b
K0831 0010 3 Power wheelchair, group 2 standard, seat elevator, captains chair, patient weight capacity up to and including 300 pounds Pwc gp2 std seat elevate cap
K0835 0010 3 Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds Pwc gp2 std sing pow opt s/b
K0836 0010 3 Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds Pwc gp2 std sing pow opt cap
K0837 0010 3 Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds Pwc gp 2 hd sing pow opt s/b
K0838 0010 3 Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds Pwc gp 2 hd sing pow opt cap
K0839 0010 3 Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds Pwc gp2 vhd sing pow opt s/b
K0840 0010 3 Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more Pwc gp2 xhd sing pow opt s/b
K0841 0010 3 Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds Pwc gp2 std mult pow opt s/b
K0842 0010 3 Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds Pwc gp2 std mult pow opt cap
K0843 0010 3 Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds Pwc gp2 hd mult pow opt s/b
K0848 0010 3 Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds Pwc gp 3 std seat/back
K0849 0010 3 Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds Pwc gp 3 std cap chair
K0850 0010 3 Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds Pwc gp 3 hd seat/back
K0851 0010 3 Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds Pwc gp 3 hd cap chair
K0852 0010 3 Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds Pwc gp 3 vhd seat/back
K0853 0010 3 Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds Pwc gp 3 vhd cap chair
K0854 0010 3 Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more Pwc gp 3 xhd seat/back
K0855 0010 3 Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more Pwc gp 3 xhd cap chair
K0856 0010 3 Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds Pwc gp3 std sing pow opt s/b
K0857 0010 3 Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds Pwc gp3 std sing pow opt cap
K0858 0010 3 Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds Pwc gp3 hd sing pow opt s/b
K0859 0010 3 Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds Pwc gp3 hd sing pow opt cap
K0860 0010 3 Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds Pwc gp3 vhd sing pow opt s/b
K0861 0010 3 Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds Pwc gp3 std mult pow opt s/b
K0862 0010 3 Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds Pwc gp3 hd mult pow opt s/b
K0863 0010 3 Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds Pwc gp3 vhd mult pow opt s/b
K0864 0010 3 Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more Pwc gp3 xhd mult pow opt s/b
K0868 0010 3 Power wheelchair, group 4 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds Pwc gp 4 std seat/back
K0869 0010 3 Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds Pwc gp 4 std cap chair
K0870 0010 3 Power wheelchair, group 4 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds Pwc gp 4 hd seat/back
K0871 0010 3 Power wheelchair, group 4 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds Pwc gp 4 vhd seat/back
K0877 0010 3 Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds Pwc gp4 std sing pow opt s/b
K0878 0010 3 Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds Pwc gp4 std sing pow opt cap
K0879 0010 3 Power wheelchair, group 4 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds Pwc gp4 hd sing pow opt s/b
K0880 0010 3 Power wheelchair, group 4 very heavy duty, single power option, sling/solid seat/back, patient weight 451 to 600 pounds Pwc gp4 vhd sing pow opt s/b
K0884 0010 3 Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds Pwc gp4 std mult pow opt s/b
K0885 0010 3 Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds Pwc gp4 std mult pow opt cap
K0886 0010 3 Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds Pwc gp4 hd mult pow s/b
K0890 0010 3 Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds Pwc gp5 ped sing pow opt s/b
K0891 0010 3 Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds Pwc gp5 ped mult pow opt s/b
K0898 0010 3 Power wheelchair, not otherwise classified Power wheelchair noc
K0899 0010 3 Power mobility device, not coded by dme pdac or does not meet criteria Pow mobil dev no dmepdac
K0900 0010 3 Customized durable medical equipment, other than wheelchair Cstm dme other than wheelchr
K0901 0010 3 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 Ko single upright pre ots
K0902 0010 3 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 Ko double upright pre ots
K0903 0010 3 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 Mult den insert dir carv/cam
K1001 0010 3 Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type Electronic posa treatment
K1002 0010 3 Cranial electrotherapy stimulation (ces) system, includes all supplies and accessories, any type Ces system w/supplies access
K1003 0010 3 Whirlpool tub, walk-in, portable Whirlpool tub walkin portabl
K1004 0010 3 Low frequency ultrasonic diathermy treatment device for home use, includes all components and accessories Lo freq us diathermy device
K1005 0010 3 Disposable collection and storage bag for breast milk, any size, any type, each Disp col sto bag breast milk