Wheelchair Seating - JA DME

Manual wheelchairs described by HCPCS E1161, E1231 - E1234, K0005, K0008, and K0009 are eligible for ADMC.

Guidelines for appropriate billing of HCPCS Code K0108 are found in the article Billing HCPCS Code K0108 - Wheelchair Component or Accessory, Not Otherwise Specified.

The KU modifier is used for certain wheelchair accessories and seat back cushions used with complex rehabilitative manual wheelchairs and certain manual wheelchairs. The impacted accessories and wheelchair codes include K0005, E1161, E1231-E1238 and K0008. The use of this modifier started with claims submitted on July 6, 2020 for dates of service from January 1, 2020 through June 30, 2021 and per CMS Medicare Learning Network (MLN) Matters (MM) 12345 continues for dates of service July 1, 2021.

Effective for claims with dates of service (DOS) on/after 3/1/2019, suppliers must bill each item on two separate claim lines using the RT and LT modifiers and 1 UOS on each claim line. Claim lines for HCPCS codes requiring use of the RT and LT modifiers, billed without the RT and/or LT modifiers or with the RTLT on a single claim line, will be rejected as incorrect coding. See Correct Coding - RT and LT Modifier Usage Change for more information.