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Prior Authorization Condition of Payment for HCPCS Codes K0856 and K0861 - Expanding Nationwide July 17, 2017

CMS has announced that the Prior Authorization Condition of Payment Program for HCPCS codes K0856 and K0861 is expanding nationwide for dates of service/delivery on or after July 17, 2017. Suppliers submitting claims for beneficiaries residing in any state must receive prior authorization affirmation for the following two HCPCS codes as a condition for payment before the item can be furnished or a claim can be submitted:  

  • K0856: Power wheelchair, group 3 standard., single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
  • K0861: Power wheelchair, group 3 standard., multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds

Noridian has scheduled a webinar on July 19, 2017 at 10 a.m. Central Time to discuss these changes and what they mean to your facility. Visit the Schedule of Events page to register for this webinar and watch for additional information to be posted on the Latest Updates section of the website. More information can also be found on the CMS website This link will take you to an external website. .

Last Updated Jun 22, 2017