Manual Wheelchair Bases - Policy Article

Manual wheelchair bases are covered under the DME benefit when the beneficiary meets the related LCD reasonable-and-necessary requirements and the device is intended for home use. Required documentation includes a face-to-face encounter and Written Order Prior to Delivery for specified HCPCS codes, a documented home assessment, and device-specific documentation (e.g., routine activities for K0005, detailed customization/manufacturing for K0008, and caregiver availability for transport chairs); claim modifier rules (KX/GA/GZ/GY) must be followed.

"Manual wheelchairs are covered under the Durable Medical Equipment (DME) benefit when the beneficiary meets the reasonable and necessary (R&N) requirements described in the related LCD."

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