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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 state that If an option or accessory that is included in another code is billed separately, the claim line 
will be denied as not separately payable. (Refer to Coding Guidelines section for additional information on 
correct coding.) 
 
A power seat elevation feature (E2300) and power standing feature (E2301) are non-covered because they are 
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 seat elevation or power standing feature, it will 
be denied as non-covered. 
 
POWER WHEELCHAIR DRIVE CONTROL SYSTEMS: 
 
If an attendant control (E2331) is provided in addition to a beneficiary-operated drive control system, it will be 
denied as non-covered. (See the related LCD for situations in which it is provided in place of a beneficiary-
operated system.) 
 
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. 
 
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.) 
 
An expandable controller may also be able to operate one or more of the following: 
 
    A separate display (i.e., for alternate control devices) 
 
    Other electronic devices (e.g., control of an augmentative speech device or computer through the chair's 
drive control) 
 
    An attendant control 
 
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. 
 
A switch is an electronic device which turns power to a particular function either "on" or "off". The external 
component of a switch may be either mechanical or non-mechanical. Mechanical switches involve physical 
contact in order to be activated. Examples of the external components of mechanical switches include, but are 
not limited to, toggle, button, ribbon, etc. Examples of the external components of non-mechanical switches 
include, but are not limited to, proximity, infrared, etc. Some of the codes include multiple switches. In those 
situations, each functional switch may have its own external component or multiple functional switches may be 
integrated into a single external switch component or multiple functional switches may be integrated into the 
wheelchair control interface without having a distinct external switch component. 
An attendant control is one which allows a caregiver to drive the wheelchair instead of the beneficiary. The 
attendant control is usually mounted on one of the rear canes of the wheelchair. This code is limited to 
proportional control devices, usually a joystick. Code E2331 is used when an attendant control is provided in 
addition to a beneficiary-operated drive control interface. 
 
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. You can find this information 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.