Effective March 1, 2014, upon delivery, the DME corresponding to these HCPCS codes is owned by DSS. POWERED PRESSURE-REDUCING AIR MATTRESS E0300 E0277



Similar documents
Home Medical Equipment (HME) Code Set HME Providers (251) Last Updated January 2011

For definitions, test parameters, methodology and testing facilities, contact RESNA at Contact ANSI at

Wheelchairs (Manual or Motorized)

Manual Wheelchair Coverage Criteria and Coding. Medicare Basic Coverage Criteria for any Manual Wheelchair

Local Coverage Article for Wheelchair Options/Accessories - Policy Article - Effective January 2013 (A19846)

The Ideal Solution for Hospice Care

REVISED products from the Medicare Learning Network (MLN)

The Medicare Face-to-Face Rules. for Durable Medical Equipment

Atigra T2 Seat System Notes for the Therapist

HOSPITAL AND SPECIALTY BEDS

Benefits for Home Health Power Wheelchairs to Change

Answer Key: MRADL: Mobility Related Activity of Daily Living. (Within the home) Example: Feeding, toileting, dressing, grooming.

MEDICAL POLICY. SUBJECT: WHEELCHAIRS and POWER OPERATED VEHICLES (POV s) POLICY NUMBER: CATEGORY: Equipment/Supplies

BINGO Evolution. BINGO Evolution by HOGGI. BINGO was good - we just made it better. Made in Germany

Think of the environment before printing! Fax only contains page 1!

Child Power Mobility

Invacare REA Dahlia 45 Transit Dealer Max User Weight 135Kg (21 stone)

Basic price 2.250,- Excl. VAT

Precertification & Referrals

LTC (OPTIONS / AGING WAIVER) - DME SUPPLY LIST FY 16 July 1, 2015 June 30, 2016 TABLE OF CONTENTS

TRIPLE-L. Trailers with the Power Deck Advantage

PROVIDER POLICIES & PROCEDURES

9 Advance Determination of Medicare Coverage

Indications for a PMD as Reasonable and Necessary and Types of PMD Categories Available

Mobile, Powered Positioning Multi-Purpose. Stretcher-Chairs. A Universal Care Platform TMM4 Series

SymmetriKit TM chairs. for rest, work and play

NHP Prior Authorization Required for DME, Medical Supplies, Oxygen Related Equipment, Orthotics and Prosthetics, Hearing Aids (updated 7/01/2015)

Evaluation and Medical Justification for Complex Seating Systems and Mobility Devices Addendum A: Mobility/Seating

pacific rehab Designs for Fun and Function Introducing the New HeadpodTM

Equipment Needed Power Scooters 4-Wheel HD Needed... 2 Stair Chair Lift System Needed Equipment Donations... 2

Car Seats for Children with Special Needs by Susan Agrawal

National Medical Policy

Chapter. CPT only copyright 2010 American Medical Association. All rights reserved. 17Durable Medical Equipment (DME)

Sling Guide. Joerns Healthcare. Redefining patient handling

How To Fit Out A Hospital Bed For A Patient

Swivel seats. Boot hoists. Steering aids. Hand controls. car adaptations. for all car Manufacturers SIRUSAUTOMOTIVE.CO.UK

Corporate Medical Policy Durable Medical Equipment (DME)

Invacare Uni-Recliners. Invacare. Uni-Recliners

NEW YORK STATE MEDICAID WHEELED MOBILITY EQUIPMENT, SEATING & POSITIONING COMPONENT GUIDELINES

Pronto Series Catalog

2010 APPLICATION REFERENCE GUIDE

Wheelchair Mounting Systems Comparison Matrix Michelle L. Lange, OTR, ABDA, ATP/SMS

Policy for Provision of Equipment to Clients Resident in a. Care Home or Nursing Home

User s Manual XXL Care Lift, Electrically Elevating Shower-, Commode- & Care Lift with Tilt-in-Space Seat Unit

Access To Medical Care For Individuals With Mobility Disabilities

RESTWELL RISE & RECLINE ARMCHAIRS BORG - OWNER S HANDBOOK PARTS DESCRIPTION

VEHICLE EQUIPMENT INSTRUCTIONS

Massage, Heat & Air Systems

Health Care Scales Guide. Bulletin No. C188G

Special Needs Beds: Getting Insurance or Medicaid to Pay by Susan Agrawal

RISER & INCLUSION OF LIFESTYLE IMAGERY? + RISE & RECLINE IMAGERY

SERVICE MANUAL. Product No. P1320

Dorset Wheelchair Service Item Specific Criteria for Supply.

Handicapped Accessible Home. By: Kevin and Zachary Smith

MECHANICALLY OPERATED WHEELCHAIR CONVERTIBLE STRETCHER

Advise and Do s and Don ts for low back pain

Thinix ipad Kiosk Hardware and Accessories

Basic Training Exercise Book

Cornell Digital Reading Room Ergonomics Checklist

Photo is courtesy of Enable-Me COMFORT SUPERIOR SEATING ACCESS ADJUSTABILITY. REHAB SHOWER COMMODE CHAIRS The Choice of Health Care Professionals

Corporate Medical Policy

Standing With You! Solid Seat Standing and Positioning System

RISE & RECLINERS FEATURES & SPECIFICATION CHICAGO - STANDARD & PETITE PETITE MODEL NOW AVAILABLE

DMSG_0152_0112_V4 Mamas & Papas (Holdings) Ltd Dream Swing - 1 -

Home Oxygen & Medical Equipment

MINUET 2 COMMUNITY BED RANGE

Slings & Accessories. With people in mind

SymmetriKit TM chairs for rest, work and play

Patient Slings. Owner s Operator and Maintenance Manual. DEALER: This manual must be given to the user of the product.

CAR SEAT/ STROLLER INSTRUCTION MANUAL

PLATFORM STEPLADDERS & TEMPORARY WORK PLATFORMS

ALS Society of BC Commerce Parkway Richmond, BC V6V 2X7 P: Toll free: F:

Operation Manual & Product Specification Guide

Safety Notice: Falls From Chairs

Anatomy of a Manual Wheelchair

Fuze Parts List - Canadian

2014 FURNITURE. (844)

Manoeuvring space for electric wheelchairs and scooters

Manual Wheelchairs: Set-Up & Propulsion Biomechanics

Loss Prevention Reference Note. Adjusting the Computer Workstation. Glare Viewing Distance. Line of Sight Neck Posture Arm Posture Back Posture

Why Back Safety is Important

APP LOVE WORK DESIGNED WITH LONGEVITY AND DURABILITY IN MIND.

The Ultimate in Boating Pedestals Seating and Table Systems. Stainless steel Range.

Basic Operating Instructions Table of Contents

What's New in Medicare Policy for Seating and Wheeled Mobility? ISS Acknowledgements. Outline 1/30/2015. Clinician Task Force

Hoist and sling assessment guidelines. Hoist and sling assessment guidelines

Section 14. Forklift Safety Contents 14.1 Operator Safety

Permobil M300 Corpus HD

User Manual Swifty Rehabilitation Buggy. Thomashilfen. Kinder- Reha

FUTURE MOBILITY HEALTHCARE APPRECIATES YOUR BUSINESS. OUR CUSTOMER SERVICE REPRESENTATIVES CAN BE CONTACTED AT: TO PLACE ORDERS: (905)

Computer Workstation Ergonomic Self Evaluation

The ForwardHealth Durable Medical Equipment (DME) Index and Maximum Fee Schedules

SERVICE MANUAL. Corpus 3G. Seat system for electric wheelchair

Health Care Scales Guide. Bulletin No. C188G

TOTAL HIP REPLACEMENT

Healthcare Scales Since

Uno 102. Product Description. Instruction Guide


Chapter. Some days I m so stiff. But even then, your firm yet gentle guidance always helps me move more easily. MOVING AND POSITIONING

Office of the Chief Procurement Officer Page 1 BID NUMBER RT

Transcription:

E0277 POWERED PRESSURE-REDUCING AIR MATTRESS E0300 PEDIATRIC CRIB HOSPITAL GRADE FULLY ENCLOSED WITH OR WITHOUT TOP ENCLOSURE E0301 HOSPITAL BED HEAVY DUTY EXTRA WIDE WITH WEIGHT CAPACITY GREATER THAN 350 POUNDS E0302 HOSPITAL BED EXTRA HEAVY DUTY EXTRA WIDE WITH WEIGHT CAPACITY GREATER THAN 600 P E0303 HOSPITAL BED HEAVY DUTY EXTRA WIDE WITH WEIGHT CAPACITY GREATER THAN 350 POUNDS* E0304 HOSPITAL BED EXTRA HEAVY DUTY EXTRA WIDE WITH WEIGHT CAPACITY GREATER THAN 600 P* E0260 HOSPITAL BED SEMI-ELECTRIC (HEAD AND FOOT ADJUSTMENT) WITH ANY TYPE SIDE RAILS W E0261 HOSPITAL BED SEMI-ELECTRIC (HEAD AND FOOT ADJUSTMENT) WITH ANY TYPE SIDE RAILS W E0266 HOSPITAL BED TOTAL ELECTRIC (HEAD FOOT AND HEIGHT ADJUSTMENTS) WITH ANY TYPE SID E0635 PATIENT LIFT ELECTRIC WITH SEAT OR SLING E0636 PATIENT LIFT SUPPORT AND POSITIONING SYS E0637 COMBINATION SIT TO STAND FRAME/TABLE SYSTEM ANY SIZE INCLUDING PEDIATRIC WITH SE E0639 PATIENT LIFT MOVEABLE FROM ROOM TO ROOM WITH DISASSEMBLY AND REASSEMBLY INCLUDES E0640 PATIENT LIFT FIXED SYSTEM INCLUDES ALL COMPONENTS/ACCESSORIES E0641 STANDING FRAME/TABLE SYSTEM MULTI-POSITION (E.G. THREE-WAY STANDER) ANY SIZE INC E0642 STANDING FRAME/TABLE SYSTEM MOBILE (DYNAMIC STANDER) ANY SIZE INCLUDING PEDIATRI E0958 MANUAL WHEELCHAIR ACCESSORY ONE-ARM DRIVE ATTACHMENT EACH E0983 MANUAL WHEELCHAIR ACCESSORY POWER ADD-ON TO CONVERT MANUAL WHEELCHAIR TO MOTORIZ E0984 MANUAL WHEELCHAIR ACCESSORY POWER ADD-ON TO CONVERT MANUAL WHEELCHAIR TO MOTORIZ E0985 WHEELCHAIR ACCESSORY SEAT LIFT MECHANISM E0986 MANUAL WHEELCHAIR ACCESSORY PUSH ACTIVATED POWER ASSIST EACH E0988 MANUAL WHEELCHAIR ACCESSORY LEVER-ACTIVATED WHEEL DRIVE PAIR E1002 WHEELCHAIR ACCESSORY POWER SEATING SYSTEM TILT ONLY E1003 WHEELCHAIR ACCESSORY POWER SEATING SYSTEM RECLINE ONLY WITHOUT SHEAR REDUCTION E1004 WHEELCHAIR ACCESSORY POWER SEATING SYSTEM RECLINE ONLY WITH MECHANICAL SHEAR RED E1005 WHEELCHAIR ACCESSORY POWER SEATNG SYSTEM RECLINE ONLY WITH POWER SHEAR REDUCTION E1006 WHEELCHAIR ACCESSORY POWER SEATING SYSTEM COMBINATION TILT AND RECLINE WITHOUT S E1007 WHEELCHAIR ACCESSORY POWER SEATING SYSTEM COMBINATION TILT AND RECLINE WITH ME E1008 WHEELCHAIR ACCESSORY POWER SEATING SYSTEM COMBINATION TILT AND RECLINE WITH PO

E1009 E1010 E1011 E1014 E1017 E1018 E1029 E1030 E1037 E1050 E1060 E1070 E1083 E1084 E1085 E1086 E1087 E1088 E1089 E1090 E1092 E1093 E1100 E1110 E1130 E1140 E1150 E1160 E1161 E1170 E1171 E1172 WHEELCHAIR ACCESSORY ADDITION TO POWER SEATING SYSTEM MECHANICALLY LINKED LEG EL WHEELCHAIR ACCESSORY ADDITION TO POWER SEATING SYSTEM POWER LEG ELEVATION SYSTEM MODIFICATION TO PEDIATRIC SIZE WHEELCHAIR WIDTH ADJUSTMENT PACKAGE (NOT TO BE DI RECLINING BACK ADDITION TO PEDIATRIC SIZE WHEELCHAIR HEAVY-DUTY SHOCK ABSORBER FOR HEAVY-DUTY OR EXTRA HEAVY-DUTY MANUAL WHEELCHAIR E HEAVY-DUTY SHOCK ABSORBER FOR HEAVY-DUTY OR EXTRA HEAVY-DUTY POWER WHEELCHAIR EA WHEELCHAIR ACCESSORY VENTILATOR TRAY FIXED WHEELCHAIR ACCESSORY VENTILATOR TRAY GIMBALED TRANSPORT CHAIR PEDIATRIC SIZE FULLY-RECLINING WHEELCHAIR FIXED FULL LENGTH ARMS SWING AWAY DETACHABLE ELEVATIN FULLY-RECLINING WHEELCHAIR DETACHABLE ARMS DESK OR FULL LENGTH SWING AWAY DETACH FULLY-RECLINING WHEELCHAIR DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY DETA HEMI-WHEELCHAIR FIXED FULL LENGTH ARMS SWING AWAY DETACHABLE ELEVATING LEG REST HEMI-WHEELCHAIR DETACHABLE ARMS DESK OR FULL LENGTH ARMS SWING AWAY DETACHABLE E HEMI-WHEELCHAIR FIXED FULL LENGTH ARMS SWING AWAY DETACHABLE FOOT RESTS HEMI-WHEELCHAIR DETACHABLE ARMS DESK OR FULL LENGTH SWING AWAY DETACHABLE FOOTRE HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR FIXED FULL LENGTH ARMS SWING AWAY DETACHABL HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR DETACHABLE ARMS DESK OR FULL LENGTH SWING A HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR FIXED LENGTH ARMS SWING AWAY DETACHABLE F HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR DETACHABLE ARMS DESK OR FULL LENGTH SWING A WIDE HEAVY DUTY WHEEL CHAIR DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY D WIDE HEAVY DUTY WHEELCHAIR DETACHABLE ARMS DESK OR FULL LENGTH ARMS SWING AWAY D SEMI-RECLINING WHEELCHAIR FIXED FULL LENGTH ARMS SWING AWAY DETACHABLE ELEVATING SEMI-RECLINING WHEELCHAIR DETACHABLE ARMS (DESK OR FULL LENGTH) ELEVATING LEG STANDARD WHEELCHAIR FIXED FULL LENGTH ARMS FIXED OR SWING AWAY DETACHABLE FOOTRE WHEELCHAIR DETACHABLE ARMS DESK OR FULL LENGTH SWING AWAY DETACHABLE FOOTRESTS WHEELCHAIR DETACHABLE ARMS DESK OR FULL LENGTH SWING AWAY DETACHABLE ELEVATING L WHEELCHAIR FIXED FULL LENGTH ARMS SWING AWAY DETACHABLE ELEVATING LEGRESTS MANUAL ADULT SIZE WHEELCHAIR INCLUDES TILT IN SPACE AMPUTEE WHEELCHAIR FIXED FULL LENGTH ARMS SWING AWAY DETACHABLE ELEVATING LEGRES AMPUTEE WHEELCHAIR FIXED FULL LENGTH ARMS WITHOUT FOOTRESTS OR LEGREST AMPUTEE WHEELCHAIR DETACHABLE ARMS (DESK OR FULL LENGTH) WITHOUT FOOTRESTS OR

E1180 E1190 E1195 E1200 E1220 E1221 E1222 E1223 E1224 E1225 E1226 E1227 E1228 E1229 E1230 E1231 E1232 E1233 E1234 E1235 E1236 E1237 E1238 E1240 E1250 E1260 E1270 E1280 E1285 E1290 E1295 E1296 AMPUTEE WHEELCHAIR DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY DETACHABLE F AMPUTEE WHEELCHAIR DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY DETACHABLE E HEAVY DUTY WHEELCHAIR FIXED FULL LENGTH ARMS SWING AWAY DETACHABLE ELEVATING L AMPUTEE WHEELCHAIR FIXED FULL LENGTH ARMS SWING AWAY DETACHABLE FOOTREST WHEELCHAIR; SPECIALLY SIZED OR CONSTRUCTED (INDICATE BRAND NAME MODEL NUMBER IF WHEELCHAIR WITH FIXED ARM FOOTRESTS WHEELCHAIR WITH FIXED ARM ELEVATING LEGRESTS WHEELCHAIR WITH DETACHABLE ARMS FOOTRESTS WHEELCHAIR WITH DETACHABLE ARMS ELEVATING LEGRESTS WHEELCHAIR ACCESSORY MANUAL SEMI-RECLINING BACK (RECLINE GREATER THAN 15 DEGREES WHEELCHAIR ACCESSORY MANUAL FULLY RECLINING BACK (RECLINE GREATER THAN 80 DEGREE SPECIAL HEIGHT ARMS FOR WHEELCHAIR SPECIAL BACK HEIGHT FOR WHEELCHAIR WHEELCHAIR PEDIATRIC SIZE NOT OTHERWISE SPECIFIED POWER OPERATED VEHICLE (THREE OR FOUR WHEEL NONHIGHWAY) SPECIFY BRAND NAME AND WHEELCHAIR PEDIATRIC SIZE TILT-IN-SPACE RIGID ADJUSTABLE WITH SEATING SYSTEM WHEELCHAIR PEDIATRIC SIZE TILT-IN-SPACE FOLDING ADJUSTABLE WITH SEATING SYSTEM WHEELCHAIR PEDIATRIC SIZE TILT-IN-SPACE RIGID ADJUSTABLE WITHOUT SEATING SYSTEM WHEELCHAIR PEDIATRIC SIZE TILT-IN-SPACE FOLDING ADJUSTABLE WITHOUT SEATING SYSTE WHEELCHAIR PEDIATRIC SIZE RIGID ADJUSTABLE WITH SEATING SYSTEM WHEELCHAIR PEDIATRIC SIZE FOLDING ADJUSTABLE WITH SEATING SYSTEM WHEELCHAIR PEDIATRIC SIZE RIGID ADJUSTABLE WITHOUT SEATING SYSTEM WHEELCHAIR PEDIATRIC SIZE FOLDING ADJUSTABLE WITHOUT SEATING SYSTEM LIGHTWEIGHT WHEELCHAIR DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY DETACHAB LIGHTWEIGHT WHEELCHAIR FIXED FULL LENGTH ARMS SWING AWAY DETACHABLE FOOTREST LIGHTWEIGHT WHEELCHAIR DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY DETACHAB LIGHTWEIGHT WHEELCHAIR FIXED FULL LENGTH ARMS SWING AWAY DETACHABLE ELEVATING LE HEAVY DUTY WHEELCHAIR DETACHABLE ARMS (DESK OR FULL LENGTH) ELEVATING LEGRESTS HEAVY DUTY WHEELCHAIR FIXED FULL LENGTH ARMS SWING AWAY DETACHABLE FOOTREST HEAVY DUTY WHEELCHAIR DETACHABLE ARMS (DESK OR FULL LENGTH) SWING AWAY DETACHABL HEAVY DUTY WHEELCHAIR FIXED FULL LENGTH ARMS ELEVATING LEGREST SPECIAL WHEELCHAIR SEAT HEIGHT FROM FLOOR

E2201 E2202 E2203 E2204 E2227 E2228 E2230 E2291 E2292 E2293 E2294 E2295 E2300 E2301 E2331 E2340 E2341 E2342 E2343 E2366 E2375 E2376 E2377 E2378 K0001 K0002 K0003 K0004 K0005 K0006 K0007 K0010 MANUAL WHEELCHAIR ACCESSORY NONSTANDARD SEAT FRAME WIDTH GREATER THAN OR EQUAL T MANUAL WHEELCHAIR ACCESSORY NONSTANDARD SEAT FRAME WIDTH 24-27 INCHES MANUAL WHEELCHAIR ACCESSORY NONSTANDARD SEAT FRAME DEPTH 20 TO LESS THAN 22 INCH MANUAL WHEELCHAIR ACCESSORY NONSTANDARD SEAT FRAME DEPTH 22 TO 25 INCHES MANUAL WHEELCHAIR ACCESSORY GEAR REDUCTION DRIVE WHEEL EACH MANUAL WHEELCHAIR ACCESSORY WHEEL BRAKING SYSTEM AND LOCK COMPLETE EACH MANUAL WHEELCHAIR ACCESSORY MANUAL STANDING SYSTEM BACK PLANAR FOR PEDIATRIC SIZE WHEELCHAIR INCLUDING FIXED ATTACHING HARDWARE SEAT PLANAR FOR PEDIATRIC SIZE WHEELCHAIR INCLUDING FIXED ATTACHING HARDWARE BACK CONTOURED FOR PEDIATRIC SIZE WHEELCHAIR INCLUDING FIXED ATTACHING HARDWARE SEAT CONTOURED FOR PEDIATRIC SIZE WHEELCHAIR INCLUDING FIXED ATTACHING HARDWARE MANUAL WHEELCHAIR ACCESSORY FOR PEDIATRIC SIZE WHEELCHAIR DYNAMIC SEATING FRAME POWER WHEELCHAIR ACCESSORY POWER SEAT ELEVATION SYSTEM POWER WHEELCHAIR ACCESSORY POWER STANDING SYSTEM POWER WHEELCHAIR ACCESSORY ATTENDANT CONTROL PROPORTIONAL INCLUDING ALL RELATED POWER WHEELCHAIR ACCESSORY NONSTANDARD SEAT FRAME WIDTH 20-23 INCHES POWER WHEELCHAIR ACCESSORY NONSTANDARD SEAT FRAME WIDTH 24-27 INCHES POWER WHEELCHAIR ACCESSORY NONSTANDARD SEAT FRAME DEPTH 20 OR 21 INCHES POWER WHEELCHAIR ACCESSORY NONSTANDARD SEAT FRAME DEPTH 22-25 INCHES POWER WHEELCHAIR ACCESSORY BATTERY CHARGER SINGLE MODE FOR USE WITH ONLY ONE BAT POWER WHEELCHAIR ACCESSORY NON-EXPANDABLE CONTROLLER INCLUDING ALL RELATED ELECT POWER WHEELCHAIR ACCESSORY EXPANDABLE CONTROLLER INCLUDING ALL RELATED ELECTRONI POWER WHEELCHAIR ACCESSORY EXPANDABLE CONTROLLER INCLUDING ALL RELATED ELECTRONI POWER WHEELCHAIR COMPONENT ACTUATOR REPLACEMENT ONLY STANDARD WHEELCHAIR STANDARD HEMI (LOW SEAT) WHEELCHAIR LIGHTWEIGHT WHEELCHAIR HIGH STRENGTH LIGHTWEIGHT WHEELCHAIR ULTRALIGHTWEIGHT WHEELCHAIR HEAVY DUTY WHEELCHAIR EXTRA HEAVY DUTY WHEELCHAIR STANDARD - WEIGHT FRAME MOTORIZED/POWER WHEELCHAIR

K0011 STANDARD - WEIGHT FRAME MOTORIZED/POWER WHEELCHAIR WITH PROGRAMMABLE CONTROL PAR K0012 LIGHTWEIGHT PORTABLE MOTORIZED/POWER WHEELCHAIR K0108 WHEELCHAIR COMPONENT OR ACCESSORY NOT OTHERWISE SPECIFIED K0800 POWER OPERATED VEHICLE GROUP 1 STANDARD PATIENT WEIGHT CAPACITY UP TO AND INCLUD K0801 POWER OPERATED VEHICLE GROUP 1 HEAVY DUTY PATIENT WEIGHT CAPACITY 301 TO 450 P K0802 POWER OPERATED VEHICLE GROUP 1 VERY HEAVY DUTY PATIENT WEIGHT CAPACITY 451 TO 60 K0806 POWER OPERATED VEHICLE GROUP 2 STANDARD PATIENT WEIGHT CAPACITY UP TO AND INCLUD K0807 POWER OPERATED VEHICLE GROUP 2 HEAVY DUTY PATIENT WEIGHT CAPACITY 301 TO 450 P K0808 POWER OPERATED VEHICLE GROUP 2 VERY HEAVY DUTY PATIENT WEIGHT CAPACITY 451 TO 60 K0812 POWER OPERATED VEHICLE NOT OTHERWISE CLASSIFIED K0813 POWER WHEELCHAIR GROUP 1 STANDARD PORTABLE SLING/SOLID SEAT AND BACK PATIENT WEI K0814 POWER WHEELCHAIR GROUP 1 STANDARD PORTABLE CAPTAINS CHAIR PATIENT WEIGHT CAPACIT K0815 POWER WHEELCHAIR GROUP 1 STANDARD SLING/SOLID SEAT AND BACK PATIENT WEIGHT CAPAC K0816 POWER WHEELCHAIR GROUP 1 STANDARD CAPTAINS CHAIR PATIENT WEIGHT CAPACITY UP TO K0820 POWER WHEELCHAIR GROUP 2 STANDARD PORTABLE SLING/SOLID SEAT/BACK PATIENT WEIGHT K0821 POWER WHEELCHAIR GROUP 2 STANDARD PORTABLE CAPTAINS CHAIR PATIENT WEIGHT CAPACIT K0822 POWER WHEELCHAIR GROUP 2 STANDARD SLING/SOLID SEAT/BACK PATIENT WEIGHT CAPACITY K0823 POWER WHEELCHAIR GROUP 2 STANDARD CAPTAINS CHAIR PATIENT WEIGHT CAPACITY UP TO K0824 POWER WHEELCHAIR GROUP 2 HEAVY DUTY SLING/SOLID SEAT/BACK PATIENT WEIGHT CAPACIT K0825 POWER WHEELCHAIR GROUP 2 HEAVY DUTY CAPTAINS CHAIR PATIENT WEIGHT CAPACITY 301 T K0826 POWER WHEELCHAIR GROUP 2 VERY HEAVY DUTY SLING/SOLID SEAT/BACK PATIENT WEIGHT CA K0827 POWER WHEELCHAIR GROUP 2 VERY HEAVY DUTY CAPTAINS CHAIR PATIENT WEIGHT CAPACITY K0828 POWER WHEELCHAIR GROUP 2 EXTRA HEAVY DUTY SLING/SOLID SEAT/BACK PATIENT WEIGHT C K0829 POWER WHEELCHAIR GROUP 2 EXTRA HEAVY DUTY CAPTAINS CHAIR PATIENT WEIGHT 601 PO K0830 POWER WHEELCHAIR GROUP 2 STANDARD SEAT ELEVATOR SLING/SOLID SEAT/BACK PATIENT WE K0831 POWER WHEELCHAIR GROUP 2 STANDARD SEAT ELEVATOR CAPTAINS CHAIR PATIENT WEIGHT CA K0835 POWER WHEELCHAIR GROUP 2 STANDARD SINGLE POWER OPTION SLING/SOLID SEAT/BACK PATI K0836 POWER WHEELCHAIR GROUP 2 STANDARD SINGLE POWER OPTION CAPTAINS CHAIR PATIENT WEI K0837 POWER WHEELCHAIR GROUP 2 HEAVY DUTY SINGLE POWER OPTION SLING/SOLID SEAT/BACK PA K0838 POWER WHEELCHAIR GROUP 2 HEAVY DUTY SINGLE POWER OPTION CAPTAINS CHAIR PATIENT W K0839 POWER WHEELCHAIR GROUP 2 VERY HEAVY DUTY SINGLE POWER OPTION SLING/SOLID SEAT/BA K0840 POWER WHEELCHAIR GROUP 2 EXTRA HEAVY DUTY SINGLE POWER OPTION SLING/SOLID SEAT/B

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 POWER WHEELCHAIR GROUP 2 STANDARD MULTIPLE POWER OPTION SLING/SOLID SEAT/BACK PA POWER WHEELCHAIR GROUP 2 STANDARD MULTIPLE POWER OPTION CAPTAINS CHAIR PATIENT W POWER WHEELCHAIR GROUP 2 HEAVY DUTY MULTIPLE POWER OPTION SLING/SOLID SEAT/BACK POWER WHEELCHAIR GROUP 3 STANDARD SLING/SOLID SEAT/BACK PATIENT WEIGHT CAPACITY POWER WHEELCHAIR GROUP 3 STANDARD CAPTAINS CHAIR PATIENT WEIGHT CAPACITY UP TO POWER WHEELCHAIR GROUP 3 HEAVY DUTY SLING/SOLID SEAT/BACK PATIENT WEIGHT CAPACIT POWER WHEELCHAIR GROUP 3 HEAVY DUTY CAPTAINS CHAIR PATIENT WEIGHT CAPACITY 301 T POWER WHEELCHAIR GROUP 3 VERY HEAVY DUTY SLING/SOLID SEAT/BACK PATIENT WEIGHT CA POWER WHEELCHAIR GROUP 3 VERY HEAVY DUTY CAPTAINS CHAIR PATIENT WEIGHT CAPACITY POWER WHEELCHAIR GROUP 3 EXTRA HEAVY DUTY SLING/SOLID SEAT/BACK PATIENT WEIGHT C POWER WHEELCHAIR GROUP 3 EXTRA HEAVY DUTY CAPTAINS CHAIR PATIENT WEIGHT CAPACITY POWER WHEELCHAIR GROUP 3 STANDARD SINGLE POWER OPTION SLING/SOLID SEAT/BACK PATI POWER WHEELCHAIR GROUP 3 STANDARD SINGLE POWER OPTION CAPTAINS CHAIR PATIENT WEI POWER WHEELCHAIR GROUP 3 HEAVY DUTY SINGLE POWER OPTION SLING/SOLID SEAT/BACK PA POWER WHEELCHAIR GROUP 3 HEAVY DUTY SINGLE POWER OPTION CAPTAINS CHAIR PATIENT W POWER WHEELCHAIR GROUP 3 VERY HEAVY DUTY SINGLE POWER OPTION SLING/SOLID SEAT/BA POWER WHEELCHAIR GROUP 3 STANDARD MULTIPLE POWER OPTION SLING/SOLID SEAT/BACK PA POWER WHEELCHAIR GROUP 3 HEAVY DUTY MULTIPLE POWER OPTION SLING/SOLID SEAT/BACK POWER WHEELCHAIR GROUP 3 VERY HEAVY DUTY MULTIPLE POWER OPTION SLING/SOLID SEAT/ POWER WHEELCHAIR GROUP 3 EXTRA HEAVY DUTY MULTIPLE POWER OPTION SLING/SOLID SE POWER WHEELCHAIR GROUP 4 STANDARD SLING/SOLID SEAT/BACK PATIENT WEIGHT CAPACITY POWER WHEELCHAIR GROUP 4 STANDARD CAPTAINS CHAIR PATIENT WEIGHT CAPACITY UP TO POWER WHEELCHAIR GROUP 4 HEAVY DUTY SLING/SOLID SEAT/BACK PATIENT WEIGHT CAPACIT POWER WHEELCHAIR GROUP 4 VERY HEAVY DUTY SLING/SOLID SEAT/BACK PATIENT WEIGHT CA POWER WHEELCHAIR GROUP 4 STANDARD SINGLE POWER OPTION SLING/SOLID SEAT/BACK PATI POWER WHEELCHAIR GROUP 4 STANDARD SINGLE POWER OPTION CAPTAINS CHAIR PATIENT WEI POWER WHEELCHAIR GROUP 4 HEAVY DUTY SINGLE POWER OPTION SLING/SOLID SEAT/BACK PA POWER WHEELCHAIR GROUP 4 VERY HEAVY DUTY SINGLE POWER OPTION SLING/SOLID SEAT/BA POWER WHEELCHAIR GROUP 4 STANDARD MULTIPLE POWER OPTION SLING/SOLID SEAT/BACK PA POWER WHEELCHAIR GROUP 4 STANDARD MULTIPLE POWER OPTION CAPTAINS CHAIR PATIENT W POWER WHEELCHAIR GROUP 4 HEAVY DUTY MULTIPLE POWER OPTION SLING/SOLID SEAT/BACK POWER WHEELCHAIR GROUP 5 PEDIATRIC SINGLE POWER OPTION SLING/SOLID SEAT/BACK PAT

K0891 K0898 K0899 E1399 POWER WHEELCHAIR GROUP 5 PEDIATRIC MULTIPLE POWER OPTION SLING/SOLID SEAT/BACK P POWER WHEELCHAIR NOT OTHERWISE CLASSIFIED POWER MOBILITY DEVICE NOT CODED BY DME PDAC OR DOES NOT MEET CRITERIA DURABLE MEDICAL EQUIPMENT, MISCELLANEOUS** *Frame only. A new mattress is required by State law **When component or accessory is associated with one of the codes above or the requested item is an enclosed or specialty bed