Showing codes K0861 (Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds) — K1007 (Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors)

K0861 - 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
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0862 - 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
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0863 - 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
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0864 - 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
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0868 - 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
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0869 - Pwc gp 4 std cap chair
Long description: Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0870 - 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
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0871 - 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
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0877 - 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
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0878 - 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
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0879 - 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
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0880 - 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
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0884 - 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
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0885 - 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
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0886 - 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
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0890 - 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
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0891 - 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
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0898 - Power wheelchair noc
Long description: Power wheelchair, not otherwise classified
Code added date: 20061001.
Code effective date: 20061001.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0899 - Pow mobil dev no dmepdac
Long description: Power mobility device, not coded by dme pdac or does not meet criteria
Code added date: 20061001.
Code effective date: 20160101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0900 - Cstm dme other than wheelchr
Long description: Customized durable medical equipment, other than wheelchair
Code added date: 20130701.
Code effective date: 20130701.
Pricing Indicator Code(s): 45 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
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K0901 - 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
Code added date: 20141001.
Code effective date: 20170101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0902 - 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
Code added date: 20141001.
Code effective date: 20170101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K0903 - Mult den insert dir carv/cam
Long description: 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
Code added date: 20180401.
Code effective date: 20190101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1 - 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.
Code added date: 19930101.
Code effective date: 19970101.
Coverage Code: C (A code denoting Medicare coverage status).
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K1001 - Electronic posa treatment
Long description: Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type
Code added date: 20200101.
Code effective date: 20240101.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1002 - Ces system
Long description: Cranial electrotherapy stimulation (ces) system, any type
Code added date: 20200101.
Code effective date: 20240101.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1003 - Whirlpool tub walkin portabl
Long description: Whirlpool tub, walk-in, portable
Code added date: 20200101.
Code effective date: 20240101.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: M (A code denoting Medicare coverage status).
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K1004 - Lo freq us diathermy device
Long description: Low frequency ultrasonic diathermy treatment device for home use
Code added date: 20200101.
Code effective date: 20231001.
Pricing Indicator Code(s): 00 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: S (A code denoting Medicare coverage status).
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K1005 - Disp col sto bag breast milk
Long description: Disposable collection and storage bag for breast milk, any size, any type, each
Code added date: 20200101.
Code effective date: 20240101.
Pricing Indicator Code(s): 46 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1006 - Suct pum ext urine mgmt sys
Long description: Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system
Code added date: 20201001.
Code effective date: 20240101.
Pricing Indicator Code(s): 36 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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K1007 - Bil hkaf pc s/d micro sensor
Long description: Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors
Code added date: 20201001.
Code effective date: 20240101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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