CANTILEVER TYPE ARMREST – CORRECT CODING


DME MAC Joint Publication

A cantilever or flip up armrest is a non-detachable armrest that pivots to move the armrest away from the patient in a fashion analogous to a swing-away armrest. There is no specific HCPCS code for this item. These types of movable armrests are included in the Basic Equipment Package for power wheelchairs and power seating systems. To bill this type of armrest separately at initial issue, the correct HCPCS code is:

A9900 - MISCELLANEOUS DME SUPPLY, ACCESSORY, AND/OR SERVICE COMPONENT OF ANOTHER HCPCS CODE

To bill this type of armrest as a repair to a covered wheelchair or seating system, the correct HCPCS code is:

K0108 - WHEELCHAIR COMPONENT OR ACCESSORY, NOT OTHERWISE SPECIFIED *

In this repair billing scenario code K0108 includes all parts necessary to replace the armrest. As a repair, K0108 must be used in combination with the appropriate repair modifier (RB – REPLACEMENT OF A PART OF DME FURNISHED AS PART OF A REPAIR).

If the entire wheelchair or seating system is being replaced, there is no separate payment for a cantilever armrest, as described above. Use HCPCS code A9900 for separate billing of the armrest in this scenario.

*Note: When a NOC (not otherwise classified/specified) code is billed the claim must be accompanied by:

  • Description of item or service
  • Product name
  • Manufacturer name

Refer to the Wheelchair Options/Accessories LCD and related Policy Article  for additional information about coverage, documentation, and coding.

For questions about correct coding, contact the Pricing, Data Analysis and Coding (PDAC) contractor Contact Center 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.

 

Published by Noridian as the PDAC, August, 2016. Republished by Palmetto GBA as the PDAC, February 2019.  Please note that links in this document were accurate at the time of original publication and may change over time and are no longer active.



Last Updated: 08/05/2016