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The rules say that plans must pay for a medical service or item if regular Medicare would pay for it in this case. 
You can find this rule at 42 Code of Federal Regulations (CFR) Section 422.101. 
 
The rules say that a power standing feature (E2301) is non-covered because it is not primarily medical in 
nature. If a wheelchair has an electrical connection device described by code E2310 or E2311 and if the sole 
function of the connection is for a power standing feature, it will be denied as non-covered 
 
Codes E2310 and E2311 describe the electronic components that allow the beneficiary to control two or more 
of the following motors from a single interface (e.g., proportional joystick, touchpad, or non-proportional 
interface): power wheelchair drive, power tilt, power recline, power shear reduction, power leg elevation, 
power seat elevation, power standing. It includes a function selection switch which allows the beneficiary to 
select the motor that is being controlled and an indicator feature to visually show which function has been 
selected. When the wheelchair drive function has been selected, the indicator feature may also show the 
direction that has been selected (forward, reverse, left, right). This indicator feature may be in a separate 
display box or may be integrated into the wheelchair interface. Payment for the code includes an allowance for 
fixed mounting hardware for the control box and for the display box. 
An expandable controller is capable of accommodating one or more of the following additional functions: 
 
Other types of proportional input devices (e.g., mini-proportional or compact joysticks, touchpads, chin control, 
head control, etc.) 
 
Non-proportional input devices (e.g., sip and puff, head array, etc.) 
 
Operate 3 or more powered seating actuators through the drive control. (Note: Control of the power seating 
actuators though the Control Input Device would require the use of an additional component, E2310 or E2311.) 
 
For power wheelchairs which are capable of being upgraded to an expandable controller (K0835, K0836, K0837, K0838, K0839, K0840, K0841, K0842, K0843, K0848, K0849, K0850, K0851, K0852, K0853, 
K0854, K0855, K0856 K0857, K0858, K0859, K0860, K0861 K0862, K0863, K0864, K0868, K0869, K0870, 
K0871, K0877, K0878, K0879, K0880, K0884, K0885, K0886, K0890, K0891), E2377 is used if an 
expandable controller is provided at the time of initial issue. Code E2376 is used with complete replacement of 
an expandable controller. 
 
A harness (E2313) describes all of the wires, fuse boxes, fuses, circuits, switches, etc. that are required for the 
operation of an expandable controller. It also includes all the necessary fasteners, connectors, and mounting 
hardware. Code E2313 is separately billable in addition to an expandable controller both at initial issue and 
with complete replacement of the expandable controller. Code K0108 must not be used for any component or 
feature of an expandable controller at the time of initial issue. The reimbursement for any type of complete 
expandable controller is included in the allowance for codes E2377/E2376 plus E2313. However, if individual 
components of the harness are replaced, code K0108 should be used. 
 
The interfaces described by codes E2312, E2321, E2322, E2325, E2327, E2328, E2329, E2330, E2373, E2374, 
E2375, E2376, E2377 must have programmable control parameters for speed adjustment, tremor dampening, 
acceleration control, and braking. 
 
Code K0108 is appropriately used at the time of initial issue only when the drive control interface that is 
provided is not included in the base code and there is no specific E code which describes it. K0108 must not be 
used for additional features of a joystick. 
 
Code K0108 is appropriately used at the time of replacement in the following situations: 
 
An integrated proportional joystick and controller box are being replaced due to damage; or 
 
An interface other than a remote joystick (e.g. sip and puff, head control) is being replaced but the controller is 
not being replaced; or 
 
There is no specific E code which describes the type of drive control interface system which is provided. 
 
Miscellaneous options, accessories, or replacement parts for wheelchairs that do not have a specific HCPCS 
code and are not included in another code should be coded K0108. If multiple miscellaneous accessories are 
provided, each should be billed on a separate claim line using code K0108. When billing more than one line 
item with code K0108, ensure that the additional information can be matched to the appropriate line item on the 
claim. It is also helpful to reference the line item to the submitted charge. If a supplier chooses to bill separately 
for a component that is included in another code, code A9900 must be used. 
 
You can find these rules in the Local Coverage Article Wheelchair Options/Accessories - Policy Article 
A52504. 
 
If you want to read these Medicare rules, you can go to this website www.medicareappeal.com. 
 
The Plan contract says that the Plan covers items and services in accordance with Medicare rules.