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HCPCS Code | Description | Billing Unit | SA Type |
|---|---|---|---|
K0108 | Hardware For Custom Seat And/Or Back | Each | Y |
K0108 | Leg Trough | Each | Y |
K0108 | Misc. Part Or Component For Use With Medical Stroller. | Each | Y |
K0108 | Wheelchair Tiedowns (also known as transit option or transit bracket) | Each | Y |
K0108 | Shoe Holders | Each | Y |
K0108 | Special/Miscellaneous Hardware or Component For Power or Manual Wheelchair Not Otherwise Specified. | Each | Y |
K0108 | Standby Switch For Use With Specially Controlled Power Mobility Device. | Each | Y |
K0108 | Subasis Bar (Swing Away Or Stationary) | Each | Y |
K0108 | Thoracic Pads With Hardware | Each | Y |
K0108 | Wheelchair Mount For Communication Device | Each | Y |
K0857 | Power Wheelchair, Group 3 Standard, Single Power Option, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0857 RR | Power Wheelchair, Group 3 Standard, Single Power Option, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0858 | Power Wheelchair, Group 3 Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Each | Y |
K0858 RR | Power Wheelchair, Group 3 Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Day | Y |
K0859 | Power Wheelchair, Group 3 Heavy Duty, Single Power Option, Captains Chair, Patient Weight Capacity 301 To 450 Pounds | Each | Y |
K0859 RR | Power Wheelchair, Group 3 Heavy Duty, Single Power Option, Captains Chair, Patient Weight Capacity 301 To 450 Pounds | Day | Y |
K0860 | Power Wheelchair, Group 3 Very Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 451 To 600 Pounds | Each | Y |
K0860 RR | Power Wheelchair, Group 3 Very Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 451 To 600 Pounds | Day | Y |
K0861 | Power Wheelchair, Group 3 Standard, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0861 RR | Power Wheelchair, Group 3 Standard, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0862 | Power Wheelchair, Group 3 Heavy Duty, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Each | Y |
K0862 RR | Power Wheelchair, Group 3 Heavy Duty, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Day | Y |
K0863 | Power Wheelchair, Group 3 Very Heavy Duty, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 451 To 600 Pounds | Each | Y |
K0863 RR | Power Wheelchair, Group 3 Very Heavy Duty, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 451 To 600 Pounds | Day | Y |
K0864 | Power Wheelchair, Group 3 Extra Heavy Duty, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 601 Pounds Or More | Each | Y |
K0864 RR | Power Wheelchair, Group 3 Extra Heavy Duty, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 601 Pounds Or More | Day | Y |
K0868 | Power Wheelchair, Group 4 Standard, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0868 RR | Power Wheelchair, Group 4 Standard, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0869 | Power Wheelchair, Group 4 Standard, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0869 RR | Power Wheelchair, Group 4 Standard, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0870 | Power Wheelchair, Group 4 Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Each | Y |
K0870 RR | Power Wheelchair, Group 4 Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Day | Y |
K0871 | Power Wheelchair, Group 4 Very Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 451 To 600 Pounds | Each | Y |
K0871 RR | Power Wheelchair, Group 4 Very Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 451 To 600 Pounds | Day | Y |
K0877 | Power Wheelchair, Group 4 Standard, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0877 RR | Power Wheelchair, Group 4 Standard, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0878 | Power Wheelchair, Group 4 Standard, Single Power Option, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0878 RR | Power Wheelchair, Group 4 Standard, Single Power Option, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0879 | Power Wheelchair, Group 4 Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Each | Y |
K0879 RR | Power Wheelchair, Group 4 Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Day | Y |
K0880 | Power Wheelchair, Group 4 Very Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight 451 To 600 Pounds | Each | Y |
K0880 RR | Power Wheelchair, Group 4 Very Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight 451 To 600 Pounds | Day | Y |
K0884 | Power Wheelchair, Group 4 Standard, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0884 RR | Power Wheelchair, Group 4 Standard, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0885 | Power Wheelchair, Group 4 Standard, Multiple Power Option, Captains Chair, Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0885 RR | Power Wheelchair, Group 4 Standard, Multiple Power Option, Captains Chair, Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0886 | Power Wheelchair, Group 4 Heavy Duty, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Each | Y |
K0886 RR | Power Wheelchair, Group 4 Heavy Duty, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Day | Y |
K0890 | Power Wheelchair, Group 5 Pediatric, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 125 Pounds | Each | Y |
K0890 RR | Power Wheelchair, Group 5 Pediatric, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 125 Pounds | Day | Y |
K0891 | Power Wheelchair, Group 5 Pediatric, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 125 Pounds | Each | Y |
K0891 RR | Power Wheelchair, Group 5 Pediatric, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 125 Pounds | Day | Y |
K0108 | Medical Stroller Type Mobility Device. | Each | Y |
K0108 | Chest Strap | Each | Y |
K0108 | Cushion Cover (Incontinence Cover) | Each | Y |
K0108 | Custom Seat And/Or Back For Wheelchair | Each | Y |
K0108 | Custom Seat Insert (Manufactured Specifically Per Patient Order) (have codes designated by cushion height) | Each | Y |
K0108 | Custom, Complex, 3 Piece Occipital Head Rest With Hardware. | Each | Y |
K0108 | Extra-Large (Greater Than 18 Wide Or 18 Deep) Low Pressure And Positioning Cushion. | Each | Y |
K0108 | Fluid Supplement Pads | Each | Y |
K0825 | Power Wheelchair, Group 2 Heavy Duty, Captains Chair, Patient Weight Capacity 301 To 450 Pounds | Each | Y |
K0825 RR | Power Wheelchair, Group 2 Heavy Duty, Captains Chair, Patient Weight Capacity 301 To 450 Pounds | Day | Y |
K0826 | Power Wheelchair, Group 2 Very Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 451 To 600 Pounds | Each | Y |
K0826 RR | Power Wheelchair, Group 2 Very Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 451 To 600 Pounds | Day | Y |
K0827 | Power Wheelchair, Group 2 Very Heavy Duty, Captains Chair, Patient Weight Capacity 451 To 600 Pounds | Each | Y |
K0827 RR | Power Wheelchair, Group 2 Very Heavy Duty, Captains Chair, Patient Weight Capacity 451 To 600 Pounds | Day | Y |
K0828 | Power Wheelchair, Group 2 Extra Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 601 Pounds Or More | Each | Y |
K0828 RR | Power Wheelchair, Group 2 Extra Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 601 Pounds Or More | Day | Y |
K0829 | Power Wheelchair, Group 2 Extra Heavy Duty, Captains Chair, Patient Weight Capacity 601 Pounds Or More | Each | Y |
K0829 RR | Power Wheelchair, Group 2 Extra Heavy Duty, Captains Chair, Patient Weight Capacity 601 Pounds Or More | Day | Y |
K0830 | Power Wheelchair, Group 2 Standard, Seat Elevator, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0830 RR | Power Wheelchair, Group 2 Standard, Seat Elevator, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0831 | Power Wheelchair, Group 2 Standard, Seat Elevator, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0831 RR | Power Wheelchair, Group 2 Standard, Seat Elevator, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0835 | Power Wheelchair, Group 2 Standard, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0835 RR | Power Wheelchair, Group 2 Standard, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0836 | Power Wheelchair, Group 2 Standard, Single Power Option, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0836 RR | Power Wheelchair, Group 2 Standard, Single Power Option, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0837 | Power Wheelchair, Group 2 Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Each | Y |
K0837 RR | Power Wheelchair, Group 2 Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Day | Y |
K0838 | Power Wheelchair, Group 2 Heavy Duty, Single Power Option, Captains Chair, Patient Weight Capacity 301 To 450 Pounds | Each | Y |
K0838 RR | Power Wheelchair, Group 2 Heavy Duty, Single Power Option, Captains Chair, Patient Weight Capacity 301 To 450 Pounds | Day | Y |
K0839 | Power Wheelchair, Group 2 Very Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 451 To 600 Pounds | Each | Y |
K0839 RR | Power Wheelchair, Group 2 Very Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 451 To 600 Pounds | Day | Y |
K0840 | Power Wheelchair, Group 2 Extra Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 601 Pounds Or More | Each | Y |
K0840 RR | Power Wheelchair, Group 2 Extra Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 601 Pounds Or More | Day | Y |
K0841 | Power Wheelchair, Group 2 Standard, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0841 RR | Power Wheelchair, Group 2 Standard, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0842 | Power Wheelchair, Group 2 Standard, Multiple Power Option, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0842 RR | Power Wheelchair, Group 2 Standard, Multiple Power Option, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0843 | Power Wheelchair, Group 2 Heavy Duty, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Each | Y |
K0843 RR | Power Wheelchair, Group 2 Heavy Duty, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Day | Y |
K0848 | Power Wheelchair, Group 3 Standard, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0848 RR | Power Wheelchair, Group 3 Standard, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0849 | Power Wheelchair, Group 3 Standard, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0849 RR | Power Wheelchair, Group 3 Standard, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0850 | Power Wheelchair, Group 3 Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Each | Y |
K0850 RR | Power Wheelchair, Group 3 Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Day | Y |
K0851 | Power Wheelchair, Group 3 Heavy Duty, Captains Chair, Patient Weight Capacity 301 To 450 Pounds | Each | Y |
K0851 RR | Power Wheelchair, Group 3 Heavy Duty, Captains Chair, Patient Weight Capacity 301 To 450 Pounds | Day | Y |
K0852 | Power Wheelchair, Group 3 Very Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 451 To 600 Pounds | Each | Y |
K0852 RR | Power Wheelchair, Group 3 Very Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 451 To 600 Pounds | Day | Y |
K0853 | Power Wheelchair, Group 3 Very Heavy Duty, Captains Chair, Patient Weight Capacity, 451 To 600 Pounds | Each | Y |
K0853 RR | Power Wheelchair, Group 3 Very Heavy Duty, Captains Chair, Patient Weight Capacity, 451 To 600 Pounds | Day | Y |
K0854 | Power Wheelchair, Group 3 Extra Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 601 Pounds Or More | Each | Y |
K0854 RR | Power Wheelchair, Group 3 Extra Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 601 Pounds Or More | Day | Y |
K0855 | Power Wheelchair, Group 3 Extra Heavy Duty, Captains Chair, Patient Weight Capacity 601 Pounds Or More | Each | Y |
K0855 RR | Power Wheelchair, Group 3 Extra Heavy Duty, Captains Chair, Patient Weight Capacity 601 Pounds Or More | Day | Y |
K0856 | Power Wheelchair, Group 3 Standard, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0856 RR | Power Wheelchair, Group 3 Standard, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0010 RR | Standard weight frame motorized/power wheelchair (Rental Only) | Day | Y |
K0011RR | Standard weight frame motorized/power wheelchair with programmable contol (Rental Only) | Day | Y |
K0012 RR | Light weight portable motorized/power wheelchair (Rental Only) | Day | Y |
K0013 | Custom motorized/power wheelchair base | Each | Y |
K0813 | Power Wheelchair, Group 1 Standard, Portable, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0813 RR | Power Wheelchair, Group 1 Standard, Portable, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0814 | Power Wheelchair, Group 1 Standard, Portable, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0814 RR | Power Wheelchair, Group 1 Standard, Portable, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0815 | Power Wheelchair, Group 1 Standard, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0815 RR | Power Wheelchair, Group 1 Standard, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0816 | Power Wheelchair, Group 1 Standard, Captains Chair, Patient Weight Capactiy Up To And Including 300 Pounds | Each | Y |
K0816 RR | Power Wheelchair, Group 1 Standard, Captains Chair, Patient Weight Capactiy Up To And Including 300 Pounds | Day | Y |
K0813 | Power Wheelchair, Group 1 Standard, Portable, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0813 RR | Power Wheelchair, Group 1 Standard, Portable, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0814 | Power Wheelchair, Group 1 Standard, Portable, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0814 RR | Power Wheelchair, Group 1 Standard, Portable, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0815 | Power Wheelchair, Group 1 Standard, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0815 RR | Power Wheelchair, Group 1 Standard, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0816 | Power Wheelchair, Group 1 Standard, Captains Chair, Patient Weight Capactiy Up To And Including 300 Pounds | Each | Y |
K0816 RR | Power Wheelchair, Group 1 Standard, Captains Chair, Patient Weight Capactiy Up To And Including 300 Pounds | Day | Y |
K0813 | Power Wheelchair, Group 1 Standard, Portable, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0813 RR | Power Wheelchair, Group 1 Standard, Portable, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0814 | Power Wheelchair, Group 1 Standard, Portable, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0814 RR | Power Wheelchair, Group 1 Standard, Portable, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0815 | Power Wheelchair, Group 1 Standard, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0815 RR | Power Wheelchair, Group 1 Standard, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0816 | Power Wheelchair, Group 1 Standard, Captains Chair, Patient Weight Capactiy Up To And Including 300 Pounds | Each | Y |
K0816 RR | Power Wheelchair, Group 1 Standard, Captains Chair, Patient Weight Capactiy Up To And Including 300 Pounds | Day | Y |
K0806 | Power Operated Vehicle, Group 2 Standard, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0806 RR | Power Operated Vehicle, Group 2 Standard, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0807 | Power Operated Vehicle, Group 2 Heavy Duty, Patient Weight Capacity 301 To 450 Pounds | Each | Y |
K0807 RR | Power Operated Vehicle, Group 2 Heavy Duty, Patient Weight Capacity 301 To 450 Pounds | Day | Y |
K0808 | Power Operated Vehicle, Group 2 Very Heavy Duty, Patient Weight Capacity 451 To 600 Pounds | Each | Y |
K0808 RR | Power Operated Vehicle, Group 2 Very Heavy Duty, Patient Weight Capacity 451 To 600 Pounds | Day | Y |
K0806 | Power Operated Vehicle, Group 2 Standard, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0806 RR | Power Operated Vehicle, Group 2 Standard, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0807 | Power Operated Vehicle, Group 2 Heavy Duty, Patient Weight Capacity 301 To 450 Pounds | Each | Y |
K0807 RR | Power Operated Vehicle, Group 2 Heavy Duty, Patient Weight Capacity 301 To 450 Pounds | Day | Y |
K0808 | Power Operated Vehicle, Group 2 Very Heavy Duty, Patient Weight Capacity 451 To 600 Pounds | Each | Y |
K0808 RR | Power Operated Vehicle, Group 2 Very Heavy Duty, Patient Weight Capacity 451 To 600 Pounds | Day | Y |
K0820 | Power Wheelchair, Group 2 Standard, Portable, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0820 RR | Power Wheelchair, Group 2 Standard, Portable, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0821 | Power Wheelchair, Group 2 Standard, Portable, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0821 RR | Power Wheelchair, Group 2 Standard, Portable, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0822 | Power Wheelchair, Group 2 Standard, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0822 RR | Power Wheelchair, Group 2 Standard, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0823 | Power Wheelchair, Group 2 Standard, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Each | Y |
K0823 RR | Power Wheelchair, Group 2 Standard, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds | Day | Y |
K0824 | Power Wheelchair, Group 2 Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Each | Y |
K0824 RR | Power Wheelchair, Group 2 Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds | Day | Y |
E1171 RR | Amputee Wheelchair, Fixed Full Length Arms, Without Foot Rests Or Leg Rests | Day | N |
E1172 | Amputee Wheelchair, Detachable Arms (Desk Or Full Length), W/O Foot Or Leg Rests | Each | N |
E1172 RR | Amputee Wheelchair, Detachable Arms (Desk Or Full Length), W/O Foot Or Leg Rests | Day | N |
E1180 | Amputee Wheelchair, Detachable Arms (Desk Or Full Length), Swing Away Det. Foot Rests | Each | N |
E1180 RR | Amputee Wheelchair, Detachable Arms (Desk Or Full Length), Swing Away Detachable Foot Rests | Day | N |
E1190 | Amputee Wheelchair, Detachable Arms (Desk Or Full Length) Swing Away, Detachable, Elevating Leg Rests | Each | N |
E1190 RR | Amputee Wheelchair, Detachable Arms (Desk Or Full Length), Swing Away, Detachable, Elevating Leg Rests | Day | N |
E1200 | Amputee Wheelchair, Fixed Full Length Arms, Swing Away, Detachable Foot Rests | Each | N |
E1200 RR | Amputee Wheelchair, Fixed Full Length Arms, Swing Away Detachable Foot Rests | Day | N |
E1231 | Wheelchair, Pediatric Size, Tilt-In-Space, Rigid, Adjustable, With Seating System | Each | Y |
E1231 RR | Wheelchair, Pediatric Size, Tilt-In-Space, Rigid, Adjustable, With Seating System | Day | Y |
E1232 | Wheelchair, Pediatric Size, Tilt-In-Space, Folding, Adjustable, With Seating System | Each | Y |
E1232 RR | Wheelchair, Pediatric Size, Tilt-In-Space, Folding, Adjustable, With Seating System | Day | Y |
E1233 | Wheelchair, Pediatric Size, Tilt-In-Space, Rigid, Adjustable, Without Seating System | Each | Y |
E1233 RR | Wheelchair, Pediatric Size, Tilt-In-Space, Rigid, Adjustable, Without Seating System | Day | Y |
E1234 | Wheelchair, Pediatric Size, Tilt-In-Space, Folding, Adjustable, Without Seating System | Each | Y |
E1234 RR | Wheelchair, Pediatric Size, Tilt-In-Space, Folding, Adjustable, Without Seating System | Day | Y |
E1235 | Wheelchair, Pediatric Size, Rigid, Adjustable, With Seating System | Each | Y |
E1235 RR | Wheelchair, Pediatric Size, Rigid, Adjustable, With Seating System | Day | Y |
E1236 | Wheelchair, Pediatric Size, Folding, Adjustable, With Seating System | Each | Y |
E1236 RR | Wheelchair, Pediatric Size, Folding, Adjustable, With Seating System | Day | Y |
E1237 | Wheelchair, Pediatric Size, Rigid, Adjustable, Without Seating System | Each | Y |
E1237 RR | Wheelchair, Pediatric Size, Rigid, Adjustable, Without Seating System | Day | Y |
E1238 | Wheelchair, Pediatric Size, Folding, Adjustable, Without Seating System | Each | Y |
E1238 RR | Wheelchair, Pediatric Size, Folding, Adjustable, Without Seating System | Day | Y |
E1240 | Lightweight Wheelchair, Detachable Arms, (Desk Or Full Length) Swing Away, Detachable Elevating Leg Rests | Each | N |
E1240 RR | Lightweight Wheelchair, Detachable Arms, (Desk Or Full Length), Swing Away, Detachable Elevating Leg Rests | Day | N |
E1250 | Lightweight Wheelchair, Fixed Full Length Arms, Swing Away, Detachable Foot Rests | Each | N |
E1250 RR | Lightweight Wheelchair, Fixed Full Length Arms, Swing Away, Detachable Foot Rests | Day | N |
E1260 | Lightweight Wheelchair, Detachable Arms Desk Or Full Length, Swing Away, Detachable Footrests | Each | N |
E1260 RR | Lightweight Wheelchair, Detachable Arms, Desk Or Full Length, Swing Away, Detachable Footrests | Day | N |
E1270 | Lightweight Wheelchair, Fixed Full Length Arms, Swing Away, Detachable Elevating Leg Rests | Each | N |
E1270 RR | Lightweight Wheelchair, Fixed Full Length Arms, Swing Away, Detachable Elevating Leg Rests | Day | N |
K0003 | Lightweight Wheelchair | Each | Y |
K0003 RR | Lightweight Wheelchair | Day | N |
K0001 | Standard Wheelchair | Each | Y |
K0001 RR | Standard Wheelchair | Day | N |
K0004 | High Strength Wheelchair | Each | Y |
K0004 RR | High Strength Wheelchair | Day | N |
K0005 | Ultralightweight Wheelchair | Each | Y |
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