HCPCS K-Codes
Durable Medical Equipment for Medicare Administrative Contractors (DME MACs)

Temporary K codes are developed by the DME MACs to report supplies and other products for which a national code has not yet been developed. Payment jurisdiction lies with the DME MACs unless otherwise specified.

• K0001

  Standard wheelchair

• K0002

  Standard hemi (low seat) wheelchair

• K0003

  Lightweight wheelchair

• K0004

  High strength, lightweight wheelchair

• K0005

  Ultralightweight wheelchair

• K0006

  Heavy duty wheelchair

• K0007

  Extra heavy duty wheelchair

• K0008

  Custom manual wheelchair/base

• K0009

  Other manual wheelchair/base

• K0010

  Standard - weight frame motorized/power wheelchair

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  Continued

• K0011

  Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking

• K0012

  Lightweight portable motorized/power wheelchair

• K0013

  Custom motorized/power wheelchair base

• K0014

  Other motorized/power wheelchair base

• K0015

  Detachable, non-adjustable height armrest, replacement only, each

• K0017

  Detachable, adjustable height armrest, base, replacement only, each

• K0018

  Detachable, adjustable height armrest, upper portion, replacement only, each

• K0019

  Arm pad, replacement only, each

• K0020

  Fixed, adjustable height armrest, pair

• K0037

  High mount flip-up footrest, each

• K0038

  Leg strap, each

• K0039

  Leg strap, h style, each

• K0040

  Adjustable angle footplate, each

• K0041

  Large size footplate, each

• K0042

  Standard size footplate, replacement only, each

• K0043

  Footrest, lower extension tube, replacement only, each

• K0044

  Footrest, upper hanger bracket, replacement only, each

• K0045

  Footrest, complete assembly, replacement only, each

• K0046

  Elevating legrest, lower extension tube, replacement only, each

• K0047

  Elevating legrest, upper hanger bracket, replacement only, each

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  Continued

• K0050

  Ratchet assembly, replacement only

• K0051

  Cam release assembly, footrest or legrest, replacement only, each

• K0052

  Swingaway, detachable footrests, replacement only, each

• K0053

  Elevating footrests, articulating (telescoping), each

• K0056

  Seat height less than 17" or equal to or greater than 21" for a high strength, lightweight, or ultralightweight wheelchair

• K0065

  Spoke protectors, each

• K0069

  Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each

• K0070

  Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each

• K0071

  Front caster assembly, complete, with pneumatic tire, replacement only, each

• K0072

  Front caster assembly, complete, with semi-pneumatic tire, replacement only, each

• K0073

  Caster pin lock, each

• K0077

  Front caster assembly, complete, with solid tire, replacement only, each

• K0098

  Drive belt for power wheelchair, replacement only

• K0105

  Iv hanger, each

• K0108

  Wheelchair component or accessory, not otherwise specified

• K0195

  Elevating leg rests, pair (for use with capped rental wheelchair base)

• K0455

  Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)

• K0462

  Temporary replacement for patient owned equipment being repaired, any type

• K0552

  Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each

• K0553

  Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service