Question 1

What is HCPCS code K0854?

Accepted Answer

HCPCS code K0854 is "Pwc gp 3 xhd seat/back". Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more

Question 2

What category is K0854 in?

Accepted Answer

K0854 belongs to HCPCS Category K (Temporary DME Codes).

Question 3

When should I use HCPCS code K0854?

Accepted Answer

Use K0854 when billing for pwc gp 3 xhd seat/back. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is K0854 covered by Medicare?

Accepted Answer

Coverage for K0854 (Pwc gp 3 xhd seat/back) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for K0854?

Accepted Answer

Documentation for K0854 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).