Retired - Manual Wheelchair Bases
Recently it has been brought to the attention of the Pricing, Data Analysis and Coding Contractor (PDAC) that manufacturers are submitting incomplete wheelchair bases on Coding Verification Review Applications. For Medicare payment purposes a manual wheelchair HCPCS codes describes a complete product as described in the bundling table contained in the Wheelchair Options and Accessories LCD. Column I codes contains all of the items listed in Column II.
|
Column I |
Column II |
|
Power Operated Vehicle (K0800-K0812) |
All options and accessories |
|
Rollabout Chair (E1031) |
All options and accessories |
|
Transport Chair (E1037, E1038, E1039) |
All options and accessories except E0990, K0195 |
|
Manual Wheelchair Base (E1161, E1229, E1231, E1232, E1233, E1234, E1235, E1236, E1237, E1238, K0001, K0002, K0003, K0004, K0005, K0006, K0007, K0009) |
E0967, E0981, E0982, E0995, E2205, E2206, E2210, E2220, E2221, E2222, E2224, E2225, E2226, K0015, K0017, K0018, K0019, K0042, K0043, K0044, K0045, K0046, K0047, K0050, K0052, K0069, K0070, K0071, K0072 |
|
Power Wheelchair Base Groups 1 and 2 (K0813-K0843) |
E0971, E0978, E0981, E0982, E0995, E1225, E2366, E2367, E2368, E2369, E2370, E2374, E2375, E2376, E2378, E2381, E2382, E2383, E2384, E2385, E2386, E2387, E2388, E2389, E2390, E2391, E2392, E2394, E2395, E2396, K0015, K0017, K0018, K0019, K0037, K0040, K0041, K0042, K0043, K0044, K0045, K0046, K0047, K0051, K0052, K0098 |
|
Power Wheelchair Base Groups 3, 4, and 5 (K0848-K0891) |
E0971, E0978, E0981, E0982, E0995, E1225, E2366, E2367, E2368, E2369, E2370, E2374, E2375, E2376, E2378, E2381, E2382, E2383, E2384, E2385, E2386, E2387, E2388, E2389, E2390, E2391, E2392, E2394, E2395, E2396, K0015, K0017, K0018, K0019, K0037, K0041, K0042, K0043, K0044, K0045, K0046, K0047, K0051, K0052, K0098 |
|
E0973 |
K0017, K0018, K0019 |
|
E0950 |
E1028 |
|
E0990 |
E0995, K0042, K0043, K0044, K0045, K0046, K0047 |
|
Power tilt and/or recline seating systems (E1002, E1003, E1004, E1005, E1006, E1007, E1008) |
E0973, K0015, K0017, K0018, K0019, K0020, K0042, K0043, K0044, K0045, K0046, K0047, K0050, K0051, K0052 |
|
E1009, E1010 |
E0990, E0995, K0042, K0043, K0044, K0045, K0046, K0047, K0052, K0053, K0195 |
|
E2325 |
E1028 |
|
E1020 |
E1028 |
|
K0039 |
K0038 |
|
K0045 |
K0043, K0044 |
|
K0046 |
K0043 |
|
K0047 |
K0044 |
|
K0053 |
E0990, E0995, K0042, K0043, K0044, K0045, K0046, K0047 |
|
K0069 |
E2220, E2224 |
|
K0070 |
E2211, E2212, E2224 |
|
K0071 |
E2214, E2215, E2225, E2226 |
|
K0072 |
E2219, E2225, E2226 |
|
K0077 |
E2221, E2222, E2225, E2226 |
|
K0195 |
E0995, K0042, K0043, K0044, K0045, K0046, K0047 |
A manual wheelchair base includes but is not limited to:
- a complete frame
- propulsion wheels and brakes
- casters
- a seat or seat pan (which can accommodate a wheelchair seat cushion or other seating system)
- a back frame
- standard leg and footrests
- armrests
- safety accessories (other than those separately billable in the Wheelchair Accessories Local Coverage Determination).
As described above, the following HCPCS codes are included in the allowance for the base wheelchair on initial issue:
| E0967 | MANUAL WHEELCHAIR ACCESSORY HAND RIM WITH PROJECTIONS ANY TYPE EACH |
| E0981 | WHEELCHAIR ACCESSORY SEAT UPHOLSTERY REPLACEMENT ONLY EACH |
| E0982 | WHEELCHAIR ACCESSORY BACK UPHOLSTERY REPLACEMENT ONLY EACH |
| E0995 | WHEELCHAIR ACCESSORY CALF REST/PAD EACH |
| E2205 | MANUAL WHEELCHAIR ACCESSORY HANDRIM WITHOUT PROJECTIONS (INCLUDES ERGONOMIC OR CONTOURED) ANY TYPE REPLACEMENT ONLY EACH |
| E2206 | MANUAL WHEELCHAIR ACCESSORY WHEEL LOCK ASSEMBLY COMPLETE EACH |
| E2210 | WHEELCHAIR ACCESSORY BEARINGS ANY TYPE REPLACEMENT ONLY EACH |
| E2220 | MANUAL WHEELCHAIR ACCESSORY SOLID (RUBBER/PLASTIC) PROPULSION TIRE ANY SIZE EACH |
| E2221 | MANUAL WHEELCHAIR ACCESSORY SOLID (RUBBER/PLASTIC) CASTER TIRE (REMOVABLE) ANY SIZE EACH |
| E2222 | MANUAL WHEELCHAIR ACCESSORY SOLID (RUBBER/PLASTIC) CASTER TIRE WITH INTEGRATED WHEEL |
| E2224 | MANUAL WHEELCHAIR ACCESSORY PROPULSION WHEEL EXCLUDES TIRE ANY SIZE EACH |
| E2225 | MANUAL WHEELCHAIR ACCESSORY CASTER WHEEL EXCLUDES TIRE ANY SIZE REPLACEMENT ONLY |
| E2226 | MANUAL WHEELCHAIR ACCESSORY CASTER FORK ANY SIZE REPLACEMENT ONLY EACH |
| K0015 | DETACHABLE NON-ADJUSTABLE HEIGHT ARMREST EACH |
| K0017 | DETACHABLE ADJUSTABLE HEIGHT ARMREST BASE EACH |
| K0018 | DETACHABLE ADJUSTABLE HEIGHT ARMREST UPPER PORTION EACH |
| K0019 | ARM PAD EACH |
| K0042 | STANDARD SIZE FOOTPLATE EACH |
| K0043 | FOOTREST LOWER EXTENSION TUBE EACH |
| K0044 | FOOTREST UPPER HANGER BRACKET EACH |
| K0045 | FOOTREST COMPLETE ASSEMBLY |
| K0046 | ELEVATING LEGREST LOWER EXTENSION TUBE EACH |
| K0047 | ELEVATING LEGREST UPPER HANGER BRACKET EACH |
| K0050 | RATCHET ASSEMBLY |
| K0052 | SWINGAWAY DETACHABLE FOOTRESTS EACH |
| K0069 | REAR WHEEL ASSEMBLY COMPLETE WITH SOLID TIRE SPOKES OR MOLDED EACH |
| K0070 | REAR WHEEL ASSEMBLY COMPLETE WITH PNEUMATIC TIRE SPOKES OR MOLDED EACH |
| K0071 | FRONT CASTER ASSEMBLY COMPLETE WITH PNEUMATIC TIRE EACH |
| K0072 | FRONT CASTER ASSEMBLY COMPLETE WITH SEMI-PNEUMATIC TIRE EACH |
Manual wheelchairs submitted to the PDAC that are incomplete will receive a “No HCPCS Code Assigned” designation. If the manual wheelchair base is incomplete, any accessories associated with the application will not be processed.
| Date | Update |
|---|---|
| 10/01/2013 | Published on PDAC website |
| 03/11/2014 | Revised - K0077 added to list of accessories included in allowance for base wheelchair on initial issue |