Article - Wheelchair Options/Accessories - Policy Article (A52504)

The KC modifier would never be used at the time of initial issue of a wheelchair. The KC modifier specifically states replacement, therefore, the RB modifier is not required.OTHER POWER WHEELCHAIR ACCESSORIES:A drive wheel is one which is directly controlled by the motor of the power wheelchair. It may be either a rear wheel, mid wheel, or front wheel, depending on the model of the power wheelchair.A caster is a smaller wheel that is in contact with the ground during normal operation of the wheelchair and which not directly controlled by the motor. It may be in the front and/or rear, depending on the location of the drive wheel.A pneumatic tire (E2381, E2384) is a rubber tire which is used in conjunction with a separate tube (E2382, E2385) which is filled with air.A flat free insert (E2383) is a removable ring of firm material that is placed inside of a pneumatic tire to allow the wheelchair to continue to move if the pneumatic tire is punctured. This code may not be used for a foam filled tire.A foam filled tire (E2386, E2387) is one in which a rubber tire shell has been filled with foam which is non-removable.A foam tire (E2388, E2389) is one which is made entirely of self-skinning urethane.A solid tire (E2390, E2391, E2392) is one which is made of hard plastic or rubber.All types of tires and wheels are included in the code for a power mobility base. Codes E2381, E2382, E2383, E2384, E2385, E2386, E2387, E2388, E2389, E2390, E2391, E2392, E2393, E2394, E2395, E2396 may only be used for replacements other than at the time of initial issue.Code E2351 describes an electronic interface used with a speech generating device. An electronic interface that is used to allow lights or other electrical devices to be operated using the power wheelchair control interface must be billed with code A9270 (non-covered item).Codes E2368, E2369, E2370 are for a replacement motor and/or gearbox. These codes are not used at the time of initial issue. If the item is a rebuilt component, the UE (used DME) modifier must be added to the code.MISCELLANEOUS:Code E1028 is used forSwingaway hardware used with remote joysticks or touchpads,Swingaway or flip-down hardware for head control interfaces E2327, E2328, E2329, E2330, andSwingaway hardware for an indicator display box that is related to the multi-motor electronic connection codes E2310 or E2311.Code E1028 is not to be used for swingaway hardware used with a sip and puff interface (E2325) because swingaway hardware is included in the allowance for that code. Code E1028 is not to be used for hardware on a wheelchair tray (E0950). Do not use E1028 in addition to E1020 (Residual limb support system) as it includes swingaway hardware.Code E1029 describes a ventilator tray which is attached in a fixed position to the wheelchair base or back. Code E1030 describes a ventilator tray which is attached to the seat back and is articulated so that the tray will remain horizontal when the seat back is raised or lowered.Code E1225 describes a manually operated reclining back that can recline greater than 15 degrees but less than 80 degrees. Code E1226 describes a manually operated reclining back that reclines 80 degrees or greater.Code E2398 describes a wheelchair component attached to a wheelchair frame that allows for dynamic movement of the seat back or pelvis component in response to increased musculoskeletal tone or spasticity.A Column II code is included in the allowance for the corresponding Column I code when provided at the same time. When multiple codes are listed in column I, all the codes in column II relate to each code in column IColumn IColumn IIPower Operated Vehicle (K0800, K0801, K0802, K0806, K0807, K0808, K0812)All options and accessoriesRollabout Chair (E1031)All options and accessoriesTransport Chair (E1037, E1038, E1039)All options and accessories except E0990, K0195Manual Wheelchair Base (E1161, E1229, E1231, E1232, E1233, E1234, E1235, E1236, E1237, E1238, K0001, K0002, K0003, K0004, K0005, K0006, K0007, K0009)E0967, E0981, E0982, E0995, E2205, E2206, E2210, E2220, E2221, E2222, E2224, E2225, E2226, K0015, K0017, K0018, K0019, K0042, K0043, K0044, K0045, K0046, K0047, K0050, K0052, K0069, K0070, K0071, K0072, K0077Power Wheelchair Base Groups 1 and 2 (K0813, K0814, K0815, K0816, K0820, K0821, K0822, K0823, K0824, K0825, K0826, K0827, K0828, K0829, K0830, K0831, K0835, K0836, K0837, K0838, K0839, K0840, K0841, K0842, K0843)E0971, E0978, E0981, E0982, E0995, E1225, E2366, E2367, E2368, E2369, E2370, E2374, E2375, E2376, E2378, E2381, E2382, E2383, E2384, E2385, E2386, E2387, E2388, E2389, E2390, E2391, E2392, E2394, E2395, E2396, K0015, K0017, K0018, K0019, K0037, K0040, K0041, K0042, K0043, K0044, K0045, K0046, K0047, K0051, K0052, K0077, K0098Power Wheelchair Base Groups 3, 4, and 5 (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)E0971, E0978, E0981, E0982, E0995, E1225, E2366, E2367, E2368, E2369, E2370, E2374, E2375, E2376, E2378, E2381, E2382, E2383, E2384, E2385, E2386, E2387, E2388, E2389, E2390, E2391, E2392, E2394, E2395, E2396, K0015, K0017, K0018, K0019, K0037, K0041, K0042, K0043, K0044, K0045, K0046, K0047, K0051, K0052, K0077, K0098E0973K0017, K0018, K0019E0950E1028E0954E1028E0990E0995, K0042, K0043, K0044, K0045, K0046, K0047Power tilt and/or recline seating systems (E1002, E1003, E1004, E1005, E1006, E1007, E1008)E0973, K0015, K0017, K0018, K0019, K0020, K0042, K0043, K0044, K0045, K0046, K0047, K0050, K0051, K0052E1009, E1010, E1012E0990, E0995, K0042, K0043, K0044, K0045, K0046, K0047, K0052, K0053, K0195E2325E1028E1020E1028K0039K0038K0045K0043, K0044K0046K0043K0047K0044K0053E0990, E0995, K0042, K0043, K0044, K0045, K0046, K0047K0069E2220, E2224K0070E2211, E2212, E2224K0071E2214, E2215, E2225, E2226K0072E2219, E2225, E2226K0077E2221, E2222, E2225, E2226K0195E0995, K0042, K0043, K0044, K0045, K0046, K0047Suppliers should contact the Pricing, Data Analysis, and Coding (PDAC) contractor for guidance on correct coding of these items.