Manual Wheelchair Bases - Correct Coding - Revised
Joint DME MAC Publication
This replaces a previous version published March 11, 2014.
Recently, manual wheelchair coding applications describing products that are not complete, functional manual wheelchairs have been received by the Pricing, Data Analysis and Coding (PDAC) contractor.
For Medicare coding purposes, all manual wheelchair base codes describe a complete product. A complete manual wheelchair base includes:
- A complete frame
- Propulsion wheels
- A sling seat, seat pan which can accommodate a wheelchair seat cushion, or a seat frame structured in such a way as to be capable of accepting a seating system
- A sling back, other seat back support which can accommodate a wheelchair back cushion, or a back frame structured in such a way as to be capable of accepting a back system
- Standard leg and footrests
- Safety accessories (other than those separately billable in the Wheelchair Accessories Local Coverage Determination)
- Rollabout Chair (E1031)
- Transport Chairs (E1037, E1038, E1039)
- Manual Wheelchair Bases (E1161, E1229, E1231, E1232, E1233, E1234, E1235, E1236, E1237, E1238, K0001, K0002, K0003, K0004, K0005, K0006, K0007, K0009)
PDAC coding applications for manual wheelchairs that describe incomplete products will receive a "No HCPCS Code Assigned" determination. If the manual wheelchair base is incomplete, any accessories associated with the application will not be processed.
For questions about correct coding, contact the Pricing, Data Analysis, and Coding contractor (PDAC) 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.
|10/01/2013||Published on PDAC website|
|03/11/2014||Revised - K0077 added to list of accessories included in allowance for base wheelchair on initial issue|