K-Codes
Durable Medical Equipment (Temporary)
K0000–K0999
- K0001Standard wheelchair
- K0002Standard hemi (low seat) wheelchair
- K0003Lightweight wheelchair
- K0004High strength, lightweight wheelchair
- K0005Ultralightweight wheelchair
- K0006Heavy duty wheelchair
- K0007Extra heavy duty wheelchair
- K0008Custom manual wheelchair/base
- K0009Other manual wheelchair/base
- K0010Standard - weight frame motorized/power wheelchair
- K0011Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking
- K0012Lightweight portable motorized/power wheelchair
- K0013Custom motorized/power wheelchair base
- K0014Other motorized/power wheelchair base
- K0015Detachable, non-adjustable height armrest, replacement only, each
- K0017Detachable, adjustable height armrest, base, replacement only, each
- K0018Detachable, adjustable height armrest, upper portion, replacement only, each
- K0019Arm pad, replacement only, each
- K0020Fixed, adjustable height armrest, pair
- K0037High mount flip-up footrest, each
- K0038Leg strap, each
- K0039Leg strap, h style, each
- K0040Adjustable angle footplate, each
- K0041Large size footplate, each
- K0042Standard size footplate, replacement only, each
- K0043Footrest, lower extension tube, replacement only, each
- K0044Footrest, upper hanger bracket, replacement only, each
- K0045Footrest, complete assembly, replacement only, each
- K0046Elevating legrest, lower extension tube, replacement only, each
- K0047Elevating legrest, upper hanger bracket, replacement only, each
- K0050Ratchet assembly, replacement only
- K0051Cam release assembly, footrest or legrest, replacement only, each
- K0052Swingaway, detachable footrests, replacement only, each
- K0053Elevating footrests, articulating (telescoping), each
- K0056Seat height less than 17" or equal to or greater than 21" for a high strength, lightweight, or ultralightweight wheelchair
- K0065Spoke protectors, each
- K0069Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each
- K0070Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each
- K0071Front caster assembly, complete, with pneumatic tire, replacement only, each
- K0072Front caster assembly, complete, with semi-pneumatic tire, replacement only, each
- K0073Caster pin lock, each
- K0077Front caster assembly, complete, with solid tire, replacement only, each
- K0098Drive belt for power wheelchair, replacement only
- K0105Iv hanger, each
- K0108Wheelchair component or accessory, not otherwise specified
- K0195Elevating leg rests, pair (for use with capped rental wheelchair base)
- K0455Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)
- K0462Temporary replacement for patient owned equipment being repaired, any type
- K0552Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each
- K0553Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service
- K0554Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system
- K0601Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each
- K0602Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each
- K0603Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each
- K0604Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each
- K0605Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each
- K0606Automatic external defibrillator, with integrated electrocardiogram analysis, garment type
- K0607Replacement battery for automated external defibrillator, garment type only, each
- K0608Replacement garment for use with automated external defibrillator, each
- K0609Replacement electrodes for use with automated external defibrillator, garment type only, each
- K0669Wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from dme pdac
- K0672Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each
- K0730Controlled dose inhalation drug delivery system
- K0733Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)
- K0738Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing
- K0739Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes
- K0740Repair or nonroutine service for oxygen equipment requiring the skill of a technician, labor component, per 15 minutes
- K0743Suction pump, home model, portable, for use on wounds
- K0744Absorptive wound dressing for use with suction pump, home model, portable, pad size 16 square inches or less
- K0745Absorptive 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
- K0746Absorptive wound dressing for use with suction pump, home model, portable, pad size greater than 48 square inches
- K0800Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds
- K0801Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds
- K0802Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds
- K0806Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds
- K0807Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds
- K0808Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds
- K0812Power operated vehicle, not otherwise classified
- K0813Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds
- K0814Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds
- K0815Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds
- K0816Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds
- K0820Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds
- K0821Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds
- K0822Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
- K0823Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds
- K0824Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
- K0825Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds
- K0826Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
- K0827Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds
- K0828Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more
- K0829Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more
- K0830Power wheelchair, group 2 standard, seat elevator, sling/solid seat/back, patient weight capacity up to and including 300 pounds
- K0831Power wheelchair, group 2 standard, seat elevator, captains chair, patient weight capacity up to and including 300 pounds
- K0835Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
- K0836Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
- K0837Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
- K0838Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds
- K0839Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
- K0840Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more
- K0841Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
- K0842Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds
- K0843Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
- K0848Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
- K0849Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds
- K0850Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
- K0851Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds
- K0852Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
- K0853Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds
- K0854Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more
- K0855Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more
- K0856Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
- K0857Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
- K0858Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds
- K0859Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds
- K0860Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
- K0861Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
- K0862Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
- K0863Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
- K0864Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more
- K0868Power wheelchair, group 4 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
- K0869Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds
- K0870Power wheelchair, group 4 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
- K0871Power wheelchair, group 4 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
- K0877Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
- K0878Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
- K0879Power wheelchair, group 4 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
- K0880Power wheelchair, group 4 very heavy duty, single power option, sling/solid seat/back, patient weight 451 to 600 pounds
- K0884Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
- K0885Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds
- K0886Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
- K0890Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
- K0891Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
- K0898Power wheelchair, not otherwise classified
- K0899Power mobility device, not coded by dme pdac or does not meet criteria
- K0900Customized durable medical equipment, other than wheelchair
- K0901Knee 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
- K0902Knee 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
- K0903For 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
K1000–K1999
- K1001Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type
- K1002Cranial electrotherapy stimulation (ces) system, any type
- K1003Whirlpool tub, walk-in, portable
- K1004Low frequency ultrasonic diathermy treatment device for home use
- K1005Disposable collection and storage bag for breast milk, any size, any type, each
- K1006Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system
- K1007Bilateral 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
- K1009Speech volume modulation system, any type, including all components and accessories
- K1010Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each
- K1011Activation device for intraurethral drainage device with valve, replacement only, each
- K1012Charger and base station for intraurethral activation device, replacement only
- K1013Enema tube, with or without adapter, any type, replacement only, each
- K1014Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control
- K1015Foot, adductus positioning device, adjustable
- K1016Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve
- K1017Monthly supplies for use of device coded at k1016
- K1018External upper limb tremor stimulator of the peripheral nerves of the wrist
- K1019Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist
- K1020Non-invasive vagus nerve stimulator
- K1021Exsufflation belt, includes all supplies and accessories
- K1022Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type
- K1023Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm
- K1024Non-pneumatic compression controller with sequential calibrated gradient pressure
- K1025Non-pneumatic sequential compression garment, full arm
- K1026Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical
- K1027Oral device/appliance used to reduce upper airway collapsibility, without fixed mechanical hinge, custom fabricated, includes fitting and adjustment
- K1028Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by phone application
- K1029Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by phone application, 90-day supply
- K1030External recharging system for battery (internal) for use with implanted cardiac contractility modulation generator, replacement only
- K1031Non-pneumatic compression controller without calibrated gradient pressure
- K1032Non-pneumatic sequential compression garment, full leg
- K1033Non-pneumatic sequential compression garment, half leg
- K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count
- K1035Molecular diagnostic test reader, nonprescription self-administered and self-collected use, fda approved, authorized or cleared
- K1036Supplies and accessories (e.g., transducer) for low frequency ultrasonic diathermy treatment device, per month
- K1037Docking station for use with oral device/appliance used to reduce upper airway collapsibility