Mobility Aids & Wheelchairs - Holistic Medical Supply

M06A: WHEELCHAIRS - STANDARD MANUAL RELATED ACCESSORIES AND REPAIRS (BOC Category)

TRANSFER DEVICE, ANY TYPE, EACH

HCPCS Code

E0705

WHEELCHAIR ACCESSORY, TRAY, EACH

HCPCS Code

E0950

HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE STRAP, EACH

HCPCS Code

E0951

TOE LOOP/HOLDER, ANY TYPE, EACH

HCPCS Code

E0952

WHEELCHAIR ACCESSORY, LATERAL THIGH OR KNEE SUPPORT, ANY TYPE INCLUDING FIXED MOUNTING HARDWARE, EACH

HCPCS Code

E0953

WHEELCHAIR ACCESSORY, FOOT BOX, ANY TYPE, INCLUDES ATTACHMENT AND MOUNTING HARDWARE, EACH FOOT

HCPCS Code

E0954

MANUAL WHEELCHAIR ACCESSORY, WHEEL LOCK BRAKE EXTENSION (HANDLE), EACH

HCPCS Code

E0961

MANUAL WHEELCHAIR ACCESSORY, ANTI-TIPPING DEVICE, EACH

HCPCS Code

E0971

MANUAL WHEELCHAIR ACCESSORY, ANTI-ROLLBACK DEVICE, EACH

HCPCS Code

E0974

WHEELCHAIR ACCESSORY, POSITIONING BELT/SAFETY BELT/PELVIC STRAP, EACH

HCPCS Code

E0978

WHEELCHAIR ACCESSORY, SEAT UPHOLSTERY, REPLACEMENT ONLY, EACH

HCPCS Code

E0981

WHEELCHAIR ACCESSORY, BACK UPHOLSTERY, REPLACEMENT ONLY, EACH

HCPCS Code

E0982

MANUAL WHEELCHAIR ACCESSORY, LEVER-ACTIVATED, WHEEL DRIVE, PAIR

HCPCS Code

E0988

WHEELCHAIR ACCESSORY, ELEVATING LEG REST, COMPLETE ASSEMBLY, EACH

HCPCS Code

E0990

WHEELCHAIR ACCESSORY, CALF REST/PAD, REPLACEMENT ONLY, EACH

HCPCS Code

E0995

MODIFICATION TO PEDIATRIC SIZE WHEELCHAIR, WIDTH ADJUSTMENT PACKAGE (NOT TO BE DISPENSED WITH INITIAL CHAIR)

HCPCS Code

E1011

SHOCK ABSORBER FOR MANUAL WHEELCHAIR, EACH

HCPCS Code

E1015

HEAVY DUTY SHOCK ABSORBER FOR HEAVY DUTY OR EXTRA HEAVY DUTY MANUAL WHEELCHAIR, EACH

HCPCS Code

E1017

RESIDUAL LIMB SUPPORT SYSTEM FOR WHEELCHAIR, ANY TYPE

HCPCS Code

E1020

WHEELCHAIR ACCESSORY, MANUAL SWINGAWAY, RETRACTABLE OR REMOVABLE MOUNTING HARDWARE, OTHER

HCPCS Code

E1028

WHEELCHAIR ACCESSORY, VENTILATOR TRAY, FIXED

HCPCS Code

E1029

WHEELCHAIR ACCESSORY, VENTILATOR TRAY, GIMBALED

HCPCS Code

E1030

WHEELCHAIR ACCESSORY, MANUAL FULLY RECLINING BACK, (RECLINE GREATER THAN 80 DEGREES), EACH

HCPCS Code

E1226

MANUAL WHEELCHAIR ACCESSORY, HANDRIM WITHOUT PROJECTIONS (INCLUDES ERGONOMIC OR CONTOURED), ANY TYPE, REPLACEMENT ONLY, EACH

HCPCS Code

E2205

MANUAL WHEELCHAIR ACCESSORY, WHEEL LOCK ASSEMBLY, COMPLETE, REPLACEMENT ONLY, EACH

HCPCS Code

E2206

WHEELCHAIR ACCESSORY, CRUTCH AND CANE HOLDER, EACH

HCPCS Code

E2207

WHEELCHAIR ACCESSORY, CYLINDER TANK CARRIER, EACH

HCPCS Code

E2208

ACCESSORY, ARM TROUGH, WITH OR WITHOUT HAND SUPPORT, EACH

HCPCS Code

E2209

WHEELCHAIR ACCESSORY, BEARINGS, ANY TYPE, REPLACEMENT ONLY, EACH

HCPCS Code

E2210

MANUAL WHEELCHAIR ACCESSORY, PNEUMATIC PROPULSION TIRE, ANY SIZE, EACH

HCPCS Code

E2211

MANUAL WHEELCHAIR ACCESSORY, TUBE FOR PNEUMATIC PROPULSION TIRE, ANY SIZE, EACH

HCPCS Code

E2212

MANUAL WHEELCHAIR ACCESSORY, INSERT FOR PNEUMATIC PROPULSION TIRE (REMOVABLE), ANY TYPE, ANY SIZE, EACH

HCPCS Code

E2213

MANUAL WHEELCHAIR ACCESSORY, PNEUMATIC CASTER TIRE, ANY SIZE, EACH

HCPCS Code

E2214

MANUAL WHEELCHAIR ACCESSORY, TUBE FOR PNEUMATIC CASTER TIRE, ANY SIZE, EACH

HCPCS Code

E2215

MANUAL WHEELCHAIR ACCESSORY, FOAM FILLED PROPULSION TIRE, ANY SIZE, EACH

HCPCS Code

E2216

MANUAL WHEELCHAIR ACCESSORY, FOAM FILLED CASTER TIRE, ANY SIZE, EACH

HCPCS Code

E2217

MANUAL WHEELCHAIR ACCESSORY, FOAM PROPULSION TIRE, ANY SIZE, EACH

HCPCS Code

E2218

MANUAL WHEELCHAIR ACCESSORY, FOAM CASTER TIRE, ANY SIZE, EACH

HCPCS Code

E2219

MANUAL WHEELCHAIR ACCESSORY, SOLID (RUBBER/PLASTIC) PROPULSION TIRE, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2220

MANUAL WHEELCHAIR ACCESSORY, SOLID (RUBBER/PLASTIC) CASTER TIRE (REMOVABLE), ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2221

MANUAL WHEELCHAIR ACCESSORY, SOLID (RUBBER/PLASTIC) CASTER TIRE WITH INTEGRATED WHEEL, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2222

MANUAL WHEELCHAIR ACCESSORY, PROPULSION WHEEL EXCLUDES TIRE, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2224

MANUAL WHEELCHAIR ACCESSORY, CASTER WHEEL EXCLUDES TIRE, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2225

MANUAL WHEELCHAIR ACCESSORY, CASTER FORK, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2226

MANUAL WHEELCHAIR ACCESSORY, GEAR REDUCTION DRIVE WHEEL, EACH

HCPCS Code

E2227

MANUAL WHEELCHAIR ACCESSORY, WHEEL BRAKING SYSTEM AND LOCK, COMPLETE, EACH

HCPCS Code

E2228

MANUAL WHEELCHAIR ACCESSORY, MANUAL STANDING SYSTEM

HCPCS Code

E2230

DETACHABLE, NON-ADJUSTABLE HEIGHT ARMREST, REPLACEMENT ONLY, EACH

HCPCS Code

K0015

DETACHABLE, ADJUSTABLE HEIGHT ARMREST, BASE, REPLACEMENT ONLY, EACH

HCPCS Code

K0017

DETACHABLE, ADJUSTABLE HEIGHT ARMREST, UPPER PORTION, REPLACEMENT ONLY, EACH

HCPCS Code

K0018

ARM PAD, REPLACEMENT ONLY, EACH

HCPCS Code

K0019

FIXED, ADJUSTABLE HEIGHT ARMREST, PAIR

HCPCS Code

K0020

HIGH MOUNT FLIP-UP FOOTREST, EACH

HCPCS Code

K0037

LEG STRAP, EACH

HCPCS Code

K0038

LEG STRAP, H STYLE, EACH

HCPCS Code

K0039

ADJUSTABLE ANGLE FOOTPLATE, EACH

HCPCS Code

K0040

LARGE SIZE FOOTPLATE, EACH

HCPCS Code

K0041

STANDARD SIZE FOOTPLATE, REPLACEMENT ONLY, EACH

HCPCS Code

K0042

FOOTREST, LOWER EXTENSION TUBE, REPLACEMENT ONLY, EACH

HCPCS Code

K0043

FOOTREST, UPPER HANGER BRACKET, REPLACEMENT ONLY, EACH

HCPCS Code

K0044

FOOTREST, COMPLETE ASSEMBLY, REPLACEMENT ONLY, EACH

HCPCS Code

K0045

ELEVATING LEGREST, LOWER EXTENSION TUBE, REPLACEMENT ONLY, EACH

HCPCS Code

K0046

ELEVATING LEGREST, UPPER HANGER BRACKET, REPLACEMENT ONLY, EACH

HCPCS Code

K0047

SWINGAWAY, DETACHABLE FOOTRESTS, REPLACEMENT ONLY, EACH

HCPCS Code

K0052

ELEVATING FOOTRESTS, ARTICULATING (TELESCOPING), EACH

HCPCS Code

K0053

SEAT HEIGHT LESS THAN 17" OR EQUAL TO OR GREATER THAN 21" FOR A HIGH STRENGTH, LIGHTWEIGHT, OR ULTRALIGHTWEIGHT WHEELCHAIR

HCPCS Code

K0056

REAR WHEEL ASSEMBLY, COMPLETE, WITH SOLID TIRE, SPOKES OR MOLDED, REPLACEMENT ONLY, EACH

HCPCS Code

K0069

REAR WHEEL ASSEMBLY, COMPLETE, WITH PNEUMATIC TIRE, SPOKES OR MOLDED, REPLACEMENT ONLY, EACH

HCPCS Code

K0070

FRONT CASTER ASSEMBLY, COMPLETE, WITH PNEUMATIC TIRE, REPLACEMENT ONLY, EACH

HCPCS Code

K0071

FRONT CASTER ASSEMBLY, COMPLETE, WITH SEMI-PNEUMATIC TIRE, REPLACEMENT ONLY, EACH

HCPCS Code

K0072

FRONT CASTER ASSEMBLY, COMPLETE, WITH SOLID TIRE, REPLACEMENT ONLY, EACH

HCPCS Code

K0077

IV HANGER, EACH

HCPCS Code

K0105

WHEELCHAIR COMPONENT OR ACCESSORY, NOT OTHERWISE SPECIFIED

HCPCS Code

K0108

ELEVATING LEG RESTS, PAIR (FOR USE WITH CAPPED RENTAL WHEELCHAIR BASE)

HCPCS Code

K0195

M07: WHEELCHAIRS - STANDARD POWER (BOC Category)

POWER WHEELCHAIR, PEDIATRIC SIZE, NOT OTHERWISE SPECIFIED

HCPCS Code

E1239

CUSTOM MOTORIZED/POWER WHEELCHAIR BASE

HCPCS Code

K0013

POWER WHEELCHAIR, GROUP 1 STANDARD, PORTABLE, SLING/SOLID SEAT AND BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS

HCPCS Code

K0813

POWER WHEELCHAIR, GROUP 1 STANDARD, PORTABLE, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS

HCPCS Code

K0814

POWER WHEELCHAIR, GROUP 1 STANDARD, SLING/SOLID SEAT AND BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS

HCPCS Code

K0815

POWER WHEELCHAIR, GROUP 1 STANDARD, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS

HCPCS Code

K0816

POWER WHEELCHAIR, GROUP 2 STANDARD, PORTABLE, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS

HCPCS Code

K0820

POWER WHEELCHAIR, GROUP 2 STANDARD, PORTABLE, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS

HCPCS Code

K0821

POWER WHEELCHAIR, GROUP 2 STANDARD, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS

HCPCS Code

K0822

POWER WHEELCHAIR, GROUP 2 STANDARD, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS

HCPCS Code

K0823

POWER WHEELCHAIR, GROUP 2 HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDS

HCPCS Code

K0824

POWER WHEELCHAIR, GROUP 2 HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY 301 TO 450 POUNDS

HCPCS Code

K0825

POWER WHEELCHAIR, GROUP 2 VERY HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDS

HCPCS Code

K0826

POWER WHEELCHAIR, GROUP 2 VERY HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY 451 TO 600 POUNDS

HCPCS Code

K0827

POWER WHEELCHAIR, GROUP 2 EXTRA HEAVY DUTY, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY 601 POUNDS OR MORE

HCPCS Code

K0828

POWER WHEELCHAIR, GROUP 2 EXTRA HEAVY DUTY, CAPTAINS CHAIR, PATIENT WEIGHT 601 POUNDS OR MORE

HCPCS Code

K0829

POWER WHEELCHAIR, GROUP 2 STANDARD, SEAT ELEVATOR, SLING/SOLID SEAT/BACK, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS

HCPCS Code

K0830

POWER WHEELCHAIR, GROUP 2 STANDARD, SEAT ELEVATOR, CAPTAINS CHAIR, PATIENT WEIGHT CAPACITY UP TO AND INCLUDING 300 POUNDS

HCPCS Code

K0831

POWER WHEELCHAIR, NOT OTHERWISE CLASSIFIED

HCPCS Code

K0898

M07A: WHEELCHAIRS - STANDARD POWER RELATED ACCESSORIES AND REPAIRS (BOC Category)

TRANSFER DEVICE, ANY TYPE, EACH

HCPCS Code

E0705

WHEELCHAIR ACCESSORY, TRAY, EACH

HCPCS Code

E0950

HEEL LOOP/HOLDER, ANY TYPE, WITH OR WITHOUT ANKLE STRAP, EACH

HCPCS Code

E0951

TOE LOOP/HOLDER, ANY TYPE, EACH

HCPCS Code

E0952

WHEELCHAIR ACCESSORY, LATERAL THIGH OR KNEE SUPPORT, ANY TYPE INCLUDING FIXED MOUNTING HARDWARE, EACH

HCPCS Code

E0953

WHEELCHAIR ACCESSORY, FOOT BOX, ANY TYPE, INCLUDES ATTACHMENT AND MOUNTING HARDWARE, EACH FOOT

HCPCS Code

E0954

WHEELCHAIR ACCESSORY, ADJUSTABLE HEIGHT, DETACHABLE ARMREST, COMPLETE ASSEMBLY, EACH

HCPCS Code

E0973

WHEELCHAIR ACCESSORY, POSITIONING BELT/SAFETY BELT/PELVIC STRAP, EACH

HCPCS Code

E0978

WHEELCHAIR ACCESSORY, SEAT UPHOLSTERY, REPLACEMENT ONLY, EACH

HCPCS Code

E0981

WHEELCHAIR ACCESSORY, BACK UPHOLSTERY, REPLACEMENT ONLY, EACH

HCPCS Code

E0982

MANUAL WHEELCHAIR ACCESSORY, POWER ADD-ON TO CONVERT MANUAL WHEELCHAIR TO MOTORIZED WHEELCHAIR, JOYSTICK CONTROL

HCPCS Code

E0983

WHEELCHAIR ACCESSORY, SEAT LIFT MECHANISM

HCPCS Code

E0985

WHEELCHAIR ACCESSORY, ELEVATING LEG REST, COMPLETE ASSEMBLY, EACH

HCPCS Code

E0990

WHEELCHAIR ACCESSORY, CALF REST/PAD, REPLACEMENT ONLY, EACH

HCPCS Code

E0995

WHEELCHAIR ACCESSORY, ADDITION TO POWER SEATING SYSTEM, CENTER MOUNT POWER ELEVATING LEG REST/PLATFORM, COMPLETE SYSTEM, ANY TYPE, EACH

HCPCS Code

E1012

SHOCK ABSORBER FOR POWER WHEELCHAIR, EACH

HCPCS Code

E1016

HEAVY DUTY SHOCK ABSORBER FOR HEAVY DUTY OR EXTRA HEAVY DUTY POWER WHEELCHAIR, EACH

HCPCS Code

E1018

RESIDUAL LIMB SUPPORT SYSTEM FOR WHEELCHAIR, ANY TYPE

HCPCS Code

E1020

WHEELCHAIR ACCESSORY, MANUAL SWINGAWAY, RETRACTABLE OR REMOVABLE MOUNTING HARDWARE, OTHER

HCPCS Code

E1028

WHEELCHAIR ACCESSORY, VENTILATOR TRAY, FIXED

HCPCS Code

E1029

WHEELCHAIR ACCESSORY, VENTILATOR TRAY, GIMBALED

HCPCS Code

E1030

WHEELCHAIR ACCESSORY, MANUAL SWINGAWAY, RETRACTABLE OR REMOVABLE MOUNTING HARDWARE USED WITH JOYSTICK OR OTHER DRIVE CONTROL INTERFACE

HCPCS Code

E1032

WHEELCHAIR ACCESSORY, MANUAL SEMI-RECLINING BACK, (RECLINE GREATER THAN 15 DEGREES, BUT LESS THAN 80 DEGREES), EACH

HCPCS Code

E1225

WHEELCHAIR ACCESSORY, MANUAL FULLY RECLINING BACK, (RECLINE GREATER THAN 80 DEGREES), EACH

HCPCS Code

E1226

WHEELCHAIR ACCESSORY, CRUTCH AND CANE HOLDER, EACH

HCPCS Code

E2207

WHEELCHAIR ACCESSORY, CYLINDER TANK CARRIER, EACH

HCPCS Code

E2208

WHEELCHAIR ACCESSORY, BEARINGS, ANY TYPE, REPLACEMENT ONLY, EACH

HCPCS Code

E2210

WHEELCHAIR ACCESSORY, POWER SEAT ELEVATION SYSTEM, ANY TYPE

HCPCS Code

E2300

POWER WHEELCHAIR ACCESSORY, GROUP 34 NON-SEALED LEAD ACID BATTERY, EACH

HCPCS Code

E2358

POWER WHEELCHAIR ACCESSORY, GROUP 34 SEALED LEAD ACID BATTERY, EACH (E.G., GEL CELL, ABSORBED GLASSMAT)

HCPCS Code

E2359

POWER WHEELCHAIR ACCESSORY, 22NF NON-SEALED LEAD ACID BATTERY, EACH

HCPCS Code

E2360

POWER WHEELCHAIR ACCESSORY, 22NF SEALED LEAD ACID BATTERY, EACH, (E.G., GEL CELL, ABSORBED GLASSMAT)

HCPCS Code

E2361

POWER WHEELCHAIR ACCESSORY, GROUP 24 NON-SEALED LEAD ACID BATTERY, EACH

HCPCS Code

E2362

POWER WHEELCHAIR ACCESSORY, GROUP 24 SEALED LEAD ACID BATTERY, EACH (E.G., GEL CELL, ABSORBED GLASSMAT)

HCPCS Code

E2363

POWER WHEELCHAIR ACCESSORY, U-1 NON-SEALED LEAD ACID BATTERY, EACH

HCPCS Code

E2364

POWER WHEELCHAIR ACCESSORY, U-1 SEALED LEAD ACID BATTERY, EACH (E.G., GEL CELL, ABSORBED GLASSMAT)

HCPCS Code

E2365

POWER WHEELCHAIR ACCESSORY, BATTERY CHARGER, SINGLE MODE, FOR USE WITH ONLY ONE BATTERY TYPE, SEALED OR NON-SEALED, EACH

HCPCS Code

E2366

POWER WHEELCHAIR ACCESSORY, BATTERY CHARGER, DUAL MODE, FOR USE WITH EITHER BATTERY TYPE, SEALED OR NON-SEALED, EACH

HCPCS Code

E2367

POWER WHEELCHAIR COMPONENT, DRIVE WHEEL MOTOR, REPLACEMENT ONLY

HCPCS Code

E2368

POWER WHEELCHAIR COMPONENT, DRIVE WHEEL GEAR BOX, REPLACEMENT ONLY

HCPCS Code

E2369

POWER WHEELCHAIR COMPONENT, INTEGRATED DRIVE WHEEL MOTOR AND GEAR BOX COMBINATION, REPLACEMENT ONLY

HCPCS Code

E2370

POWER WHEELCHAIR ACCESSORY, GROUP 27 SEALED LEAD ACID BATTERY, (E.G., GEL CELL, ABSORBED GLASSMAT), EACH

HCPCS Code

E2371

POWER WHEELCHAIR ACCESSORY, GROUP 27 NON-SEALED LEAD ACID BATTERY, EACH

HCPCS Code

E2372

POWER WHEELCHAIR ACCESSORY, NON-EXPANDABLE CONTROLLER, INCLUDING ALL RELATED ELECTRONICS AND MOUNTING HARDWARE, REPLACEMENT ONLY

HCPCS Code

E2375

POWER WHEELCHAIR COMPONENT, ACTUATOR, REPLACEMENT ONLY

HCPCS Code

E2378

POWER WHEELCHAIR ACCESSORY, PNEUMATIC DRIVE WHEEL TIRE, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2381

POWER WHEELCHAIR ACCESSORY, TUBE FOR PNEUMATIC DRIVE WHEEL TIRE, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2382

POWER WHEELCHAIR ACCESSORY, INSERT FOR PNEUMATIC DRIVE WHEEL TIRE (REMOVABLE), ANY TYPE, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2383

POWER WHEELCHAIR ACCESSORY, PNEUMATIC CASTER TIRE, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2384

POWER WHEELCHAIR ACCESSORY, TUBE FOR PNEUMATIC CASTER TIRE, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2385

POWER WHEELCHAIR ACCESSORY, FOAM FILLED DRIVE WHEEL TIRE, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2386

POWER WHEELCHAIR ACCESSORY, FOAM FILLED CASTER TIRE, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2387

POWER WHEELCHAIR ACCESSORY, FOAM DRIVE WHEEL TIRE, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2388

POWER WHEELCHAIR ACCESSORY, FOAM CASTER TIRE, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2389

POWER WHEELCHAIR ACCESSORY, SOLID (RUBBER/PLASTIC) DRIVE WHEEL TIRE, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2390

POWER WHEELCHAIR ACCESSORY, SOLID (RUBBER/PLASTIC) CASTER TIRE (REMOVABLE), ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2391

POWER WHEELCHAIR ACCESSORY, SOLID (RUBBER/PLASTIC) CASTER TIRE WITH INTEGRATED WHEEL, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2392

POWER WHEELCHAIR ACCESSORY, DRIVE WHEEL EXCLUDES TIRE, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2394

POWER WHEELCHAIR ACCESSORY, CASTER WHEEL EXCLUDES TIRE, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2395

POWER WHEELCHAIR ACCESSORY, CASTER FORK, ANY SIZE, REPLACEMENT ONLY, EACH

HCPCS Code

E2396

POWER WHEELCHAIR ACCESSORY, LITHIUM-BASED BATTERY, EACH

HCPCS Code

E2397

DETACHABLE, NON-ADJUSTABLE HEIGHT ARMREST, REPLACEMENT ONLY, EACH

HCPCS Code

K0015

DETACHABLE, ADJUSTABLE HEIGHT ARMREST, BASE, REPLACEMENT ONLY, EACH

HCPCS Code

K0017

DETACHABLE, ADJUSTABLE HEIGHT ARMREST, UPPER PORTION, REPLACEMENT ONLY, EACH

HCPCS Code

K0018

ARM PAD, REPLACEMENT ONLY, EACH

HCPCS Code

K0019

FIXED, ADJUSTABLE HEIGHT ARMREST, PAIR

HCPCS Code

K0020

HIGH MOUNT FLIP-UP FOOTREST, EACH

HCPCS Code

K0037

LEG STRAP, EACH

HCPCS Code

K0038

LEG STRAP, H STYLE, EACH

HCPCS Code

K0039

ADJUSTABLE ANGLE FOOTPLATE, EACH

HCPCS Code

K0040

LARGE SIZE FOOTPLATE, EACH

HCPCS Code

K0041

STANDARD SIZE FOOTPLATE, REPLACEMENT ONLY, EACH

HCPCS Code

K0042

FOOTREST, LOWER EXTENSION TUBE, REPLACEMENT ONLY, EACH

HCPCS Code

K0043

FOOTREST, UPPER HANGER BRACKET, REPLACEMENT ONLY, EACH

HCPCS Code

K0044

FOOTREST, COMPLETE ASSEMBLY, REPLACEMENT ONLY, EACH

HCPCS Code

K0045

ELEVATING LEGREST, LOWER EXTENSION TUBE, REPLACEMENT ONLY, EACH

HCPCS Code

K0046

ELEVATING LEGREST, UPPER HANGER BRACKET, REPLACEMENT ONLY, EACH

HCPCS Code

K0047

RATCHET ASSEMBLY, REPLACEMENT ONLY

HCPCS Code

K0050

CAM RELEASE ASSEMBLY, FOOTREST OR LEGREST, REPLACEMENT ONLY, EACH

HCPCS Code

K0051

SWINGAWAY, DETACHABLE FOOTRESTS, REPLACEMENT ONLY, EACH

HCPCS Code

K0052

ELEVATING FOOTRESTS, ARTICULATING (TELESCOPING), EACH

HCPCS Code

K0053

SEAT HEIGHT LESS THAN 17" OR EQUAL TO OR GREATER THAN 21" FOR A HIGH STRENGTH, LIGHTWEIGHT, OR ULTRALIGHTWEIGHT WHEELCHAIR

HCPCS Code

K0056

SPOKE PROTECTORS, EACH

HCPCS Code

K0065

REAR WHEEL ASSEMBLY, COMPLETE, WITH SOLID TIRE, SPOKES OR MOLDED, REPLACEMENT ONLY, EACH

HCPCS Code

K0069

REAR WHEEL ASSEMBLY, COMPLETE, WITH PNEUMATIC TIRE, SPOKES OR MOLDED, REPLACEMENT ONLY, EACH

HCPCS Code

K0070

FRONT CASTER ASSEMBLY, COMPLETE, WITH PNEUMATIC TIRE, REPLACEMENT ONLY, EACH

HCPCS Code

K0071

FRONT CASTER ASSEMBLY, COMPLETE, WITH SEMI-PNEUMATIC TIRE, REPLACEMENT ONLY, EACH

HCPCS Code

K0072

CASTER PIN LOCK, EACH

HCPCS Code

K0073

FRONT CASTER ASSEMBLY, COMPLETE, WITH SOLID TIRE, REPLACEMENT ONLY, EACH

HCPCS Code

K0077

DRIVE BELT FOR POWER WHEELCHAIR, REPLACEMENT ONLY

HCPCS Code

K0098

IV HANGER, EACH

HCPCS Code

K0105

WHEELCHAIR COMPONENT OR ACCESSORY, NOT OTHERWISE SPECIFIED

HCPCS Code

K0108

ELEVATING LEG RESTS, PAIR (FOR USE WITH CAPPED RENTAL WHEELCHAIR BASE)

HCPCS Code

K0195

POWER WHEELCHAIR ACCESSORY, 12 TO 24 AMP HOUR SEALED LEAD ACID BATTERY, EACH (E.G., GEL CELL, ABSORBED GLASSMAT)

HCPCS Code

K0733

M10: WHEELCHAIR SEATING/CUSHIONS (BOC Category)

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

HCPCS Code

A9900

WHEELCHAIR ACCESSORY, HEADREST, CUSHIONED, ANY TYPE, INCLUDING FIXED MOUNTING HARDWARE, EACH

HCPCS Code

E0955

WHEELCHAIR ACCESSORY, LATERAL TRUNK OR HIP SUPPORT, ANY TYPE, INCLUDING FIXED MOUNTING HARDWARE, EACH

HCPCS Code

E0956

WHEELCHAIR ACCESSORY, MEDIAL THIGH SUPPORT, ANY TYPE, INCLUDING FIXED MOUNTING HARDWARE, EACH

HCPCS Code

E0957

WHEELCHAIR ACCESSORY, SHOULDER HARNESS/STRAPS OR CHEST STRAP, INCLUDING ANY TYPE MOUNTING HARDWARE

HCPCS Code

E0960

MANUAL WHEELCHAIR ACCESSORY, HEADREST EXTENSION, EACH

HCPCS Code

E0966

WHEELCHAIR ACCESSORY, SEAT UPHOLSTERY, REPLACEMENT ONLY, EACH

HCPCS Code

E0981

WHEELCHAIR ACCESSORY, BACK UPHOLSTERY, REPLACEMENT ONLY, EACH

HCPCS Code

E0982

WHEELCHAIR ACCESSORY, SEAT LIFT MECHANISM

HCPCS Code

E0985

MANUAL WHEELCHAIR ACCESSORY, SOLID SEAT INSERT

HCPCS Code

E0992

WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, TILT ONLY

HCPCS Code

E1002

WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, RECLINE ONLY, WITHOUT SHEAR REDUCTION

HCPCS Code

E1003

WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, RECLINE ONLY, WITH MECHANICAL SHEAR REDUCTION

HCPCS Code

E1004

WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, RECLINE ONLY, WITH POWER SHEAR REDUCTION

HCPCS Code

E1005

WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, COMBINATION TILT AND RECLINE, WITHOUT SHEAR REDUCTION

HCPCS Code

E1006

WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, COMBINATION TILT AND RECLINE, WITH MECHANICAL SHEAR REDUCTION

HCPCS Code

E1007

WHEELCHAIR ACCESSORY, POWER SEATING SYSTEM, COMBINATION TILT AND RECLINE, WITH POWER SHEAR REDUCTION

HCPCS Code

E1008

WHEELCHAIR ACCESSORY, ADDITION TO POWER SEATING SYSTEM, MECHANICALLY LINKED LEG ELEVATION SYSTEM, INCLUDING PUSHROD AND LEG REST, EACH

HCPCS Code

E1009

WHEELCHAIR ACCESSORY, ADDITION TO POWER SEATING SYSTEM, POWER LEG ELEVATION SYSTEM, INCLUDING LEG REST, PAIR

HCPCS Code

E1010

WHEELCHAIR ACCESSORY, MANUAL SWINGAWAY, RETRACTABLE OR REMOVABLE MOUNTING HARDWARE, OTHER

HCPCS Code

E1028

WHEELCHAIR ACCESSORY, MANUAL SWINGAWAY, RETRACTABLE OR REMOVABLE MOUNTING HARDWARE FOR HEADREST, CUSHIONED, ANY TYPE

HCPCS Code

E1033

WHEELCHAIR ACCESSORY, MANUAL SWINGAWAY, RETRACTABLE OR REMOVABLE MOUNTING HARDWARE FOR LATERAL TRUNK OR HIP SUPPORT, ANY TYPE

HCPCS Code

E1034

MANUAL WHEELCHAIR ACCESSORY, NONSTANDARD SEAT FRAME, WIDTH GREATER THAN OR EQUAL TO 20 INCHES AND LESS THAN 24 INCHES

HCPCS Code

E2201

MANUAL WHEELCHAIR ACCESSORY, NONSTANDARD SEAT FRAME WIDTH, 24-27 INCHES

HCPCS Code

E2202

MANUAL WHEELCHAIR ACCESSORY, NONSTANDARD SEAT FRAME DEPTH, 20 TO LESS THAN 22 INCHES

HCPCS Code

E2203

MANUAL WHEELCHAIR ACCESSORY, NONSTANDARD SEAT FRAME DEPTH, 22 TO 25 INCHES

HCPCS Code

E2204

MANUAL WHEELCHAIR ACCESSORY, SOLID SEAT SUPPORT BASE (REPLACES SLING SEAT), INCLUDES ANY TYPE MOUNTING HARDWARE

HCPCS Code

E2231

BACK, PLANAR, FOR PEDIATRIC SIZE WHEELCHAIR INCLUDING FIXED ATTACHING HARDWARE

HCPCS Code

E2291

SEAT, PLANAR, FOR PEDIATRIC SIZE WHEELCHAIR INCLUDING FIXED ATTACHING HARDWARE

HCPCS Code

E2292

BACK, CONTOURED, FOR PEDIATRIC SIZE WHEELCHAIR INCLUDING FIXED ATTACHING HARDWARE

HCPCS Code

E2293

SEAT, CONTOURED, FOR PEDIATRIC SIZE WHEELCHAIR INCLUDING FIXED ATTACHING HARDWARE

HCPCS Code

E2294

MANUAL WHEELCHAIR ACCESSORY, FOR PEDIATRIC SIZE WHEELCHAIR, DYNAMIC SEATING FRAME, ALLOWS COORDINATED MOVEMENT OF MULTIPLE POSITIONING FEATURES

HCPCS Code

E2295

POWER WHEELCHAIR ACCESSORY, ELECTRONIC CONNECTION BETWEEN WHEELCHAIR CONTROLLER AND ONE POWER SEATING SYSTEM MOTOR, INCLUDING ALL RELATED ELECTRONICS, INDICATOR FEATURE, MECHANICAL FUNCTION SELECTION SWITCH, AND FIXED MOUNTING HARDWARE

HCPCS Code

E2310

POWER WHEELCHAIR ACCESSORY, ELECTRONIC CONNECTION BETWEEN WHEELCHAIR CONTROLLER AND TWO OR MORE POWER SEATING SYSTEM MOTORS, INCLUDING ALL RELATED ELECTRONICS, INDICATOR FEATURE, MECHANICAL FUNCTION SELECTION SWITCH, AND FIXED MOUNTING HARDWARE

HCPCS Code

E2311

WHEELCHAIR ACCESSORY, DYNAMIC POSITIONING HARDWARE FOR BACK

HCPCS Code

E2398

GENERAL USE WHEELCHAIR SEAT CUSHION, WIDTH LESS THAN 22 INCHES, ANY DEPTH

HCPCS Code

E2601

GENERAL USE WHEELCHAIR SEAT CUSHION, WIDTH 22 INCHES OR GREATER, ANY DEPTH

HCPCS Code

E2602

SKIN PROTECTION WHEELCHAIR SEAT CUSHION, WIDTH LESS THAN 22 INCHES, ANY DEPTH

HCPCS Code

E2603

SKIN PROTECTION WHEELCHAIR SEAT CUSHION, WIDTH 22 INCHES OR GREATER, ANY DEPTH

HCPCS Code

E2604

POSITIONING WHEELCHAIR SEAT CUSHION, WIDTH LESS THAN 22 INCHES, ANY DEPTH

HCPCS Code

E2605

POSITIONING WHEELCHAIR SEAT CUSHION, WIDTH 22 INCHES OR GREATER, ANY DEPTH

HCPCS Code

E2606

SKIN PROTECTION AND POSITIONING WHEELCHAIR SEAT CUSHION, WIDTH LESS THAN 22 INCHES, ANY DEPTH

HCPCS Code

E2607

SKIN PROTECTION AND POSITIONING WHEELCHAIR SEAT CUSHION, WIDTH 22 INCHES OR GREATER, ANY DEPTH

HCPCS Code

E2608

CUSTOM FABRICATED WHEELCHAIR SEAT CUSHION, ANY SIZE

HCPCS Code

E2609

WHEELCHAIR SEAT CUSHION, POWERED

HCPCS Code

E2610

GENERAL USE WHEELCHAIR BACK CUSHION, WIDTH LESS THAN 22 INCHES, ANY HEIGHT, INCLUDING ANY TYPE MOUNTING HARDWARE

HCPCS Code

E2611

GENERAL USE WHEELCHAIR BACK CUSHION, WIDTH 22 INCHES OR GREATER, ANY HEIGHT, INCLUDING ANY TYPE MOUNTING HARDWARE

HCPCS Code

E2612

POSITIONING WHEELCHAIR BACK CUSHION, POSTERIOR, WIDTH LESS THAN 22 INCHES, ANY HEIGHT, INCLUDING ANY TYPE MOUNTING HARDWARE

HCPCS Code

E2613

POSITIONING WHEELCHAIR BACK CUSHION, POSTERIOR, WIDTH 22 INCHES OR GREATER, ANY HEIGHT, INCLUDING ANY TYPE MOUNTING HARDWARE

HCPCS Code

E2614

POSITIONING WHEELCHAIR BACK CUSHION, POSTERIOR-LATERAL, WIDTH LESS THAN 22 INCHES, ANY HEIGHT, INCLUDING ANY TYPE MOUNTING HARDWARE

HCPCS Code

E2615

POSITIONING WHEELCHAIR BACK CUSHION, POSTERIOR-LATERAL, WIDTH 22 INCHES OR GREATER, ANY HEIGHT, INCLUDING ANY TYPE MOUNTING HARDWARE

HCPCS Code

E2616

CUSTOM FABRICATED WHEELCHAIR BACK CUSHION, ANY SIZE, INCLUDING ANY TYPE MOUNTING HARDWARE

HCPCS Code

E2617

REPLACEMENT COVER FOR WHEELCHAIR SEAT CUSHION OR BACK CUSHION, EACH

HCPCS Code

E2619

POSITIONING WHEELCHAIR BACK CUSHION, PLANAR BACK WITH LATERAL SUPPORTS, WIDTH LESS THAN 22 INCHES, ANY HEIGHT, INCLUDING ANY TYPE MOUNTING HARDWARE

HCPCS Code

E2620

POSITIONING WHEELCHAIR BACK CUSHION, PLANAR BACK WITH LATERAL SUPPORTS, WIDTH 22 INCHES OR GREATER, ANY HEIGHT, INCLUDING ANY TYPE MOUNTING HARDWARE

HCPCS Code

E2621

SKIN PROTECTION WHEELCHAIR SEAT CUSHION, ADJUSTABLE, WIDTH LESS THAN 22 INCHES, ANY DEPTH

HCPCS Code

E2622

SKIN PROTECTION WHEELCHAIR SEAT CUSHION, ADJUSTABLE, WIDTH 22 INCHES OR GREATER, ANY DEPTH

HCPCS Code

E2623

SKIN PROTECTION AND POSITIONING WHEELCHAIR SEAT CUSHION, ADJUSTABLE, WIDTH LESS THAN 22 INCHES, ANY DEPTH

HCPCS Code

E2624

SKIN PROTECTION AND POSITIONING WHEELCHAIR SEAT CUSHION, ADJUSTABLE, WIDTH 22 INCHES OR GREATER, ANY DEPTH

HCPCS Code

E2625

WHEELCHAIR COMPONENT OR ACCESSORY, NOT OTHERWISE SPECIFIED

HCPCS Code

K0108

WHEELCHAIR ACCESSORY, WHEELCHAIR SEAT OR BACK CUSHION, DOES NOT MEET SPECIFIC CODE CRITERIA OR NO WRITTEN CODING VERIFICATION FROM DME PDAC

HCPCS Code

K0669