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IMPORTANT: Article retired due to content incorporation into the applicable Local Coverage Determination or related Policy Article.

December 15, 2016

Manual Wheelchairs Constructed of Titanium - Correct Coding

DME MAC Joint Publication

A recent review of K0108 (WHEELCHAIR COMPONENT OR ACCESSORY, NOT OTHERWISE SPECIFIED) identified increased billing for items that are characterized by titanium construction or heavy-duty packages constructed with titanium. The HCPCS codes for manual wheelchairs (K0001-K0009*) were created in 1993, effective for dates of service on or after January 1, 1994. The HCPCS codes for manual wheelchair bases are:

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

The Medicare fee schedule amount for these codes was established with the original code and included the cost of titanium-containing manual wheelchairs. Suppliers billing for manual wheelchair bases must not include HCPCS code K0108 in addition to the base wheelchair code when a wheelchair is constructed of titanium or for a "heavy duty package" reflecting titanium construction materials. Claim HCPCS code K0108 reflecting titanium construction or "heavy duty package" comprised of titanium components, are considered as incorrect coding - unbundling.

The Manual Wheelchair Local Coverage Determination related Policy Article Coding Guidelines detail the specifications that are used to assign codes to manual wheelchair bases. Manual wheelchairs constructed of titanium are assigned coding based upon these coding guideline specifications.

Refer to the Manual Wheelchair Bases LCDExternal Website and related Policy ArticleExternal Website for additional information about coverage, coding and documentation.

For questions about correct coding, contact the Pricing, Data Analysis, and Coding (PDAC) contractor at (877) 735-1326 during the hours of 8:30 a.m. to 4:00 p.m. CT, Monday through Friday, or e-mail the PDAC by completing the DME PDAC Contact Form at https://www.dmepdac.com/External Website.

* K0008 had an effective date of October 1, 1994. This code was discontinued July 1, 2001 and reinstated July 1, 2013.

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