| K1014 | Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control |
| K1015 | Foot, adductus positioning device, adjustable |
| K1016 | Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve |
| K1017 | Monthly supplies for use of device coded at k1016 |
| K1018 | External upper limb tremor stimulator of the peripheral nerves of the wrist |
| K1019 | Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist |
| K1020 | Non-invasive vagus nerve stimulator |
| K1021 | Exsufflation belt, includes all supplies and accessories |
| K1022 | Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type |
| K1023 | Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm |
| K1024 | Non-pneumatic compression controller with sequential calibrated gradient pressure |
| K1025 | Non-pneumatic sequential compression garment, full arm |
| K1026 | Mechanical allergen particle barrier/inhalation filter, cream, nasal, topical |
| K1027 | Oral device/appliance used to reduce upper airway collapsibility, without fixed mechanical hinge, custom fabricated, includes fitting and adjustment |
| K1028 | Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle for the reduction of snoring and obstructive sleep apnea, controlled by phone application |
| K1029 | Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by phone application, 90-day supply |
| K1030 | External recharging system for battery (internal) for use with implanted cardiac contractility modulation generator, replacement only |
| K1031 | Non-pneumatic compression controller without calibrated gradient pressure |
| K1032 | Non-pneumatic sequential compression garment, full leg |
| K1033 | Non-pneumatic sequential compression garment, half leg |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
| K1035 | Molecular diagnostic test reader, nonprescription self-administered and self-collected use, fda approved, authorized or cleared |
| K0001 | Standard wheelchair |
| K0002 | Standard hemi (low seat) wheelchair |
| K0003 | Lightweight wheelchair |
| K0004 | High strength, lightweight wheelchair |
| K0005 | Ultralightweight wheelchair |
| K0006 | Heavy duty wheelchair |
| K0007 | Extra heavy duty wheelchair |
| K0008 | Custom manual wheelchair/base |
| K0009 | Other manual wheelchair/base |
| K0010 | Standard - weight frame motorized/power wheelchair |
| K0011 | Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking |
| K0012 | Lightweight portable motorized/power wheelchair |
| K0013 | Custom motorized/power wheelchair base |
| K0014 | Other motorized/power wheelchair base |
| K0015 | Detachable, non-adjustable height armrest, replacement only, each |
| K0017 | Detachable, adjustable height armrest, base, replacement only, each |
| K0018 | Detachable, adjustable height armrest, upper portion, replacement only, each |
| K0019 | Arm pad, replacement only, each |
| K0020 | Fixed, adjustable height armrest, pair |
| K0037 | High mount flip-up footrest, each |
| K0038 | Leg strap, each |
| K0039 | Leg strap, h style, each |
| K0040 | Adjustable angle footplate, each |
| K0041 | Large size footplate, each |
| K0042 | Standard size footplate, replacement only, each |
| K0043 | Footrest, lower extension tube, replacement only, each |
| K0044 | Footrest, upper hanger bracket, replacement only, each |
| K0045 | Footrest, complete assembly, replacement only, each |
| K0046 | Elevating legrest, lower extension tube, replacement only, each |
| K0047 | Elevating legrest, upper hanger bracket, replacement only, each |
| K0050 | Ratchet assembly, replacement only |
| K0051 | Cam release assembly, footrest or legrest, replacement only, each |
| K0052 | Swingaway, detachable footrests, replacement only, each |
| K0053 | Elevating footrests, articulating (telescoping), each |
| K0056 | Seat height less than 17" or equal to or greater than 21" for a high strength, lightweight, or ultralightweight wheelchair |
| K0065 | Spoke protectors, each |
| K0069 | Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each |
| K0070 | Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each |
| K0071 | Front caster assembly, complete, with pneumatic tire, replacement only, each |
| K0072 | Front caster assembly, complete, with semi-pneumatic tire, replacement only, each |
| K0073 | Caster pin lock, each |
| K0077 | Front caster assembly, complete, with solid tire, replacement only, each |
| K0098 | Drive belt for power wheelchair, replacement only |
| K0105 | Iv hanger, each |
| K0108 | Wheelchair component or accessory, not otherwise specified |
| K0195 | Elevating leg rests, pair (for use with capped rental wheelchair base) |
| K0455 | Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol) |
| K0462 | Temporary replacement for patient owned equipment being repaired, any type |
| K0552 | Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each |
| K0553 | Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
| K0554 | Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
| K0601 | Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each |
| K0602 | Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each |
| K0603 | Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each |
| K0604 | Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each |
| K0605 | Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each |
| K0606 | Automatic external defibrillator, with integrated electrocardiogram analysis, garment type |
| K0607 | Replacement battery for automated external defibrillator, garment type only, each |
| K0608 | Replacement garment for use with automated external defibrillator, each |
| K0609 | Replacement electrodes for use with automated external defibrillator, garment type only, each |
| K0669 | Wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from dme pdac |
| K0672 | Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each |
| K0730 | Controlled dose inhalation drug delivery system |
| K0733 | Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
| K0738 | Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
| K0739 | Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
| K0740 | Repair or nonroutine service for oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
| K0743 | Suction pump, home model, portable, for use on wounds |
| K0744 | Absorptive wound dressing for use with suction pump, home model, portable, pad size 16 square inches or less |
| K0745 | Absorptive wound dressing for use with suction pump, home model, portable, pad size more than 16 square inches but less than or equal to 48 square inches |
| K0746 | Absorptive wound dressing for use with suction pump, home model, portable, pad size greater than 48 square inches |
| K0800 | Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds |
| K0801 | Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds |
| K0802 | Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds |
| K0806 | Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds |
| K0807 | Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds |
| K0808 | Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds |
| K0812 | Power operated vehicle, not otherwise classified |
| K0813 | Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds |
| K0814 | Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
| K0815 | Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds |
| K0816 | Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds |
| K0820 | Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
| K0821 | Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
| K0822 | Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
| K0823 | Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
| K0824 | Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
| K0825 | Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
| K0826 | Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds |
| K0827 | Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds |
| K0828 | Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more |
| K0829 | Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more |
| K0830 | Power wheelchair, group 2 standard, seat elevator, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
| K0831 | Power wheelchair, group 2 standard, seat elevator, captains chair, patient weight capacity up to and including 300 pounds |
| K0835 | Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
| K0836 | Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds |
| K0837 | Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
| K0838 | Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds |
| K0839 | Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds |
| K0840 | Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more |
| K0841 | Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
| K0842 | Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds |
| K0843 | Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
| K0848 | Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
| K0849 | Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds |
| K0850 | Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
| K0851 | Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
| K0852 | Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds |
| K0853 | Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds |
| K0854 | Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more |
| K0855 | Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more |
| K0856 | Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
| K0857 | Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds |
| K0858 | Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds |
| K0859 | Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds |
| K0860 | Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds |
| K0861 | Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
| K0862 | Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
| K0863 | Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds |
| K0864 | Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more |
| K0868 | Power wheelchair, group 4 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
| K0869 | Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds |
| K0870 | Power wheelchair, group 4 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
| K0871 | Power wheelchair, group 4 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds |
| 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 |
| K0891 | Power wheelchair, group 5 pediatric, multiple 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 |
| K1003 | Whirlpool tub, walk-in, portable |
| K1004 | Low frequency ultrasonic diathermy treatment device for home use, includes all components and accessories |
| K1005 | Disposable collection and storage bag for breast milk, any size, any type, each |
| K1006 | Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system |
| K1007 | Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors |
| K1009 | Speech volume modulation system, any type, including all components and accessories |
| K1010 | Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each |
| K1011 | Activation device for intraurethral drainage device with valve, replacement only, each |
| K1012 | Charger and base station for intraurethral activation device, replacement only |
| K1013 | Enema tube, with or without adapter, any type, replacement only, each |
