2025 HCPCS code K0822
(Active) Effective Date: N/A Revision Date: N/A Durable medical equipment (DME) - Wheelchairs, Power Operated K codes Feed
Group 2 power wheelchair with sling/solid seat/back, standard weight capacity (up to 300 lbs).
Modifiers such as RR (rental) or BP/BU (purchase options provided to the beneficiary) may apply.
Medicare covers DME like power wheelchairs when deemed medically necessary by a physician. Prior authorization may be required. The medical necessity must be clearly documented and justified based on the patient's condition and functional limitations.
The provider must document a face-to-face encounter and the medical necessity of the power wheelchair. The patient should be capable of safe and independent operation of the wheelchair, transferring to and from it (with or without assistance), and maintaining an upright position while using it.
In simple words: This code represents a powered wheelchair for individuals weighing up to 300 pounds. It's for those who can't move around easily on their own and need the assistance of a motorized wheelchair.
Power wheelchair, group 2 standard, sling or solid seat and back, patient weight capacity up to and including 300 pounds.This code covers the supply of a group 2 power wheelchair designed for patients weighing up to 300 pounds. It features a sling or solid seat and back.This type of wheelchair is suitable for patients who cannot achieve independent movement with other mobility devices and have limited upper extremity strength.
Example 1: A patient with multiple sclerosis experiences significant weakness in their lower extremities, making ambulation impossible. They have sufficient upper body strength to operate the controls of a power wheelchair and require a group 2 standard model due to their weight., A patient with amyotrophic lateral sclerosis (ALS)has progressive muscle weakness affecting their ability to walk and self-propel a manual wheelchair. A power wheelchair is medically necessary for their mobility, and K0822 is appropriate given their weight being under 300 lbs., A patient post-stroke has limited mobility and requires a power wheelchair for independent movement within their home and community.Following a face-to-face evaluation, the physician determines K0822 is the appropriate code.
Documentation should include the patient's medical condition, mobility limitations, inability to use other mobility devices, face-to-face evaluation, and the medical necessity for a power wheelchair. Justification for the specific group and weight capacity should also be documented.
** Prior authorization is often required for power wheelchairs, especially for Medicare beneficiaries.Check with the patient's insurance provider for specific requirements.Power wheelchairs are classified into groups based on factors like size, speed, and obstacle height maneuverability.Group 2 is a common type suitable for many patients.
- Payment Status: Unknown
- Specialties:Physical Medicine and Rehabilitation, Neurology, Geriatrics
- Place of Service:Patient's Home; Skilled Nursing Facility; Inpatient Hospital (if the wheelchair is used during an inpatient stay); etc.