HCPCS Code Section: HCPCS K Codes

Arm pad, replacement only, each Short Description: Arm pad repl, each Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1994 Effective Date: …

Detachable, adjustable height armrest, upper portion, replacement only, each Short Description: Detach adjust armrst upper Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January …

Detachable, adjustable height armrest, base, replacement only, each Short Description: Detach adjust armrest base Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, …

Detachable, non-adjustable height armrest, replacement only, each Short Description: Detach non-adj ht armrst rep Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, …

Other motorized/power wheelchair base Short Description: Other power whlchr base Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1994 Effective Date: January …

Custom motorized/power wheelchair base Short Description: Custom power whlchr base Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: July 1, 2013 Effective …

Lightweight portable motorized/power wheelchair Short Description: Ltwt portbl power whlchr Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1994 Effective Date: May …

Standard – weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking Short Description: Stnd wt pwr whlchr w control Coverage Code: …

Standard – weight frame motorized/power wheelchair Short Description: Stnd wt frame power whlchr Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1994 …

Other manual wheelchair/base Short Description: Other manual wheelchair/base Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1994 Effective Date: July 1, 2013 …