K0891 – Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds

Long description

Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds

Short description

Pwc gp5 ped mult 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

• K0877 – Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 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
• K0898 – Power wheelchair, not otherwise classified
• K0899 – Power mobility device, not coded by dme pdac or does not meet criteria
• K0900 – Customized durable medical equipment, other than wheelchair
• K0901 – Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
• K0902 – Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
• K0903 – For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each
• K1001 – Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type
• K1002 – Cranial electrotherapy stimulation (ces) system, any type