Question 1

What is HCPCS code K0861?

Accepted Answer

HCPCS code K0861 is "Pwc gp3 std mult pow opt s/b". Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds

Question 2

What category is K0861 in?

Accepted Answer

K0861 belongs to HCPCS Category K (Temporary DME Codes).

Question 3

When should I use HCPCS code K0861?

Accepted Answer

Use K0861 when billing for pwc gp3 std mult pow opt s/b. 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 K0861 covered by Medicare?

Accepted Answer

Coverage for K0861 (Pwc gp3 std mult pow opt s/b) 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 K0861?

Accepted Answer

Documentation for K0861 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).