| HCPCS Code: |
K0880 |
| Long Description: |
Power wheelchair, group 4 very heavy duty, single power option, sling/solid seat/back, patient weight 451 to 600 pounds |
| Short Description: |
Pwc gp4 vhd sing pow opt s/b |
| Pricing Indicator 1: |
36 (Capped rental DME (price subject to floors and ceilings)) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| Statute Number: |
|
| Coverage Code: |
C (Carrier judgment) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
D1D (Wheelchairs) |
| Type of Service Code 1: |
A (Used durable medical equipment (DME)) |
| Type of Service Code 2: |
P (Lump sum purchase of DME, prosthetics, orthotics) |
| Type of Service Code 3: |
R (Rental of DME) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-10-2006 |
| Action Effective Date: |
01-10-2006 |
| Action Code: |
N (No maintenance for this code) |
