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K Codes
K Codes
Durable Medical Equipment For Medicare Administrative Contractors
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Codes
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
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
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
k0554
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system
k0601
Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each
k0602
Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each
k0603
Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each
k0604
Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each
k0605
Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each
k0606
Automatic external defibrillator, with integrated electrocardiogram analysis, garment type
k0607
Replacement battery for automated external defibrillator, garment type only, each
k0608
Replacement garment for use with automated external defibrillator, each
k0609
Replacement electrodes for use with automated external defibrillator, garment type only, each
k0669
Wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from dme pdac
k0672
Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each
k0730
Controlled dose inhalation drug delivery system
k0733
Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)
k0738
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing
k0739
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes
k0740
Repair or nonroutine service for oxygen equipment requiring the skill of a technician, labor component, per 15 minutes
k0743
Suction pump, home model, portable, for use on wounds
k0744
Absorptive wound dressing for use with suction pump, home model, portable, pad size 16 square inches or less
k0745
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
k0746
Absorptive wound dressing for use with suction pump, home model, portable, pad size greater than 48 square inches
k0800
Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds
k0801
Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds
k0802
Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds
k0806
Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds
k0807
Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds
k0808
Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds
k0812
Power operated vehicle, not otherwise classified
k0813
Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds
k0814
Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds
k0815
Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds
k0816
Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds
k0820
Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds
k0821
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds
k0822
Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
k0823
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds
k0824
Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
k0825
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds
k0826
Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
k0827
Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds
k0828
Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more
k0829
Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more
k0830
Power wheelchair, group 2 standard, seat elevator, sling/solid seat/back, patient weight capacity up to and including 300 pounds
k0831
Power wheelchair, group 2 standard, seat elevator, captains chair, patient weight capacity up to and including 300 pounds
k0835
Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
k0836
Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
k0837
Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
k0838
Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds
k0839
Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
k0840
Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more
k0841
Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
k0842
Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds
k0843
Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
k0848
Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
k0849
Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds
k0850
Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
k0851
Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds
k0852
Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
k0853
Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds
k0854
Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more
k0855
Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more
k0856
Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
k0857
Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
k0858
Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds
k0859
Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds
k0860
Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
k0861
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
k0862
Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
k0863
Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
k0864
Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more
k0868
Power wheelchair, group 4 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
k0869
Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds
k0870
Power wheelchair, group 4 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
k0871
Power wheelchair, group 4 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
k0877
Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
k0878
Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
k0879
Power wheelchair, group 4 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
k0880
Power wheelchair, group 4 very heavy duty, single power option, sling/solid seat/back, patient weight 451 to 600 pounds
k0884
Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
k0885
Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds
k0886
Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
k0890
Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
k0891
Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
k0898
Power wheelchair, not otherwise classified
k0899
Power mobility device, not coded by dme pdac or does not meet criteria
k0900
Customized durable medical equipment, other than wheelchair
k0901
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
k0902
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
k0903
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
k1001
Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type
k1002
Cranial electrotherapy stimulation (ces) system, includes all supplies and accessories, any type
k1003
Whirlpool tub, walk-in, portable
k1004
Low frequency ultrasonic diathermy treatment device for home use, includes all components and accessories
k1005
Disposable collection and storage bag for breast milk, any size, any type, each
k1006
Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system
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
k1009
Speech volume modulation system, any type, including all components and accessories
k1010
Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each
k1011
Activation device for intraurethral drainage device with valve, replacement only, each
k1012
Charger and base station for intraurethral activation device, replacement only
k1013
Enema tube, with or without adapter, any type, replacement only, each
k1014
Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control
k1015
Foot, adductus positioning device, adjustable
k1016
Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve
k1017
Monthly supplies for use of device coded at k1016
k1018
External upper limb tremor stimulator of the peripheral nerves of the wrist
k1019
Monthly supplies for use of device coded at k1018
k1020
Non-invasive vagus nerve stimulator
k1021
Exsufflation belt, includes all supplies and accessories
k1022
Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type
k1023
Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm
k1024
Non-pneumatic compression controller with sequential calibrated gradient pressure
k1025
Non-pneumatic sequential compression garment, full arm
k1026
Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical
k1027
Oral device/appliance used to reduce upper airway collapsibility, without fixed mechanical hinge, custom fabricated, includes fitting and adjustment
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