2025 HCPCS code K0885
Power wheelchair, group 4 standard, multiple power option, captain's chair, patient weight capacity up to and including 300 lbs.
Modifiers such as BP (purchase), BU (purchase after rental), EY (no physician order - not typically applicable in this context), GA (waiver of liability), GY and GZ (related to Medicare benefit exclusions), KX (medical policy requirements met), RA (replacement), and RB (replacement of a part) can be applicable. Always verify payer-specific guidelines.
Medicare covers DME like power wheelchairs only when deemed medically necessary by a physician. The documentation must support the patient's inability to perform activities of daily living and safely use other mobility aids.
In simple words: This code covers a powered wheelchair with extra features like a captain's chair, for people weighing up to 300 pounds who can't use regular wheelchairs or other mobility aids. A doctor needs to see the patient in person and confirm it's medically necessary.
This code covers the supply of a group 4 power wheelchair with multiple power options and a captain's chair, designed for patients weighing up to 300 pounds. These wheelchairs are for patients with impaired mobility who cannot independently use canes, walkers, or manual wheelchairs due to limited upper extremity strength. The wheelchair must be prescribed by a physician after a face-to-face evaluation documenting the medical necessity.
Example 1: A patient with multiple sclerosis experiences significant weakness in their arms and legs, making it impossible to propel a manual wheelchair. After a face-to-face evaluation, the physician determines a Group 4 power wheelchair with a captain's chair is medically necessary due to the patient's weight and mobility limitations., A patient with amyotrophic lateral sclerosis (ALS) has progressive muscle weakness and requires a power wheelchair for mobility. The patient's weight is within the 300-lb. limit, and the physician prescribes a Group 4 wheelchair with multiple power options for customized control., Following a spinal cord injury, a patient has limited upper body strength and requires a power wheelchair. The physician conducts a face-to-face evaluation, documents the medical necessity, and prescribes a K0885 power wheelchair due to the patient's specific needs and weight.
Documentation must include a face-to-face evaluation by a physician (or other qualified healthcare professional like a PA, NP, or CNS), demonstrating the medical necessity for the power wheelchair. This should include details of the patient's mobility limitations and inability to use alternative mobility devices. The patient's weight should also be recorded.
** Prior authorization may be required by some payers. Billing G9156 for the wheelchair evaluation is permissible. Ensure proper documentation regarding the patient's weight, mobility limitations, and the medical necessity for a power wheelchair with specific features.
- Specialties:Physical Medicine and Rehabilitation, Neurology, Geriatrics
- Place of Service:Patient's Home, Skilled Nursing Facility, Inpatient Hospital (if provided during an inpatient stay and intended for use post-discharge), etc.