K0877 – Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds

Long description

Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds

Short description

Pwc gp4 std sing pow opt s/b

Pricing indicator

36 DME – capped rental

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

D1D Wheelchairs

Added

October 1, 2006

Last change

October 1, 2006 – No change

Nearby K codes

• K0861 – Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
• K0862 – Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
• K0863 – Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
• K0864 – Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more
• K0868 – Power wheelchair, group 4 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
• K0869 – Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds
• K0870 – Power wheelchair, group 4 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
• K0871 – Power wheelchair, group 4 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
• K0878 – Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
• K0879 – Power wheelchair, group 4 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
• K0880 – Power wheelchair, group 4 very heavy duty, single power option, sling/solid seat/back, patient weight 451 to 600 pounds
• K0884 – Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
• K0885 – Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds
• K0886 – Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
• K0890 – Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
• K0891 – Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds