Question 1

What is HCPCS code K0864?

Accepted Answer

HCPCS code K0864 is "Pwc gp3 xhd mult pow opt s/b". Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more

Question 2

What category is K0864 in?

Accepted Answer

K0864 belongs to HCPCS Category K (Temporary DME Codes).

Question 3

When should I use HCPCS code K0864?

Accepted Answer

Use K0864 when billing for pwc gp3 xhd 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 K0864 covered by Medicare?

Accepted Answer

Coverage for K0864 (Pwc gp3 xhd 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 K0864?

Accepted Answer

Documentation for K0864 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).