Temporary K codes are developed by the DME MACs to report supplies and other products for which a national code has not yet been developed. Payment jurisdiction lies with the DME MACs unless otherwise specified.


  • K0841

    Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
  • K0842

    Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds
  • K0843

    Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
  • K0848

    Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
  • K0849

    Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds
  • K0850

    Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
  • K0851

    Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds
  • K0852

    Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
  • K0853

    Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds
  • K0854

    Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more


  • Continued
  • K0855

    Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more
  • K0856

    Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
  • K0857

    Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
  • K0858

    Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds
  • K0859

    Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds
  • K0860

    Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
  • K0861

    Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
  • K0862

    Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
  • K0863

    Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds
  • K0864

    Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more
  • K0868

    Power wheelchair, group 4 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds
  • K0869

    Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds
  • K0870

    Power wheelchair, group 4 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds
  • K0871

    Power wheelchair, group 4 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds
  • K0877

    Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
  • K0878

    Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds
  • K0879

    Power wheelchair, group 4 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
  • K0880

    Power wheelchair, group 4 very heavy duty, single power option, sling/solid seat/back, patient weight 451 to 600 pounds
  • K0884

    Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds
  • K0885

    Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds


  • Continued
  • K0886

    Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds
  • K0890

    Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
  • K0891

    Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds
  • K0898

    Power wheelchair, not otherwise classified
  • K0899

    Power mobility device, not coded by dme pdac or does not meet criteria
  • K0900

    Customized durable medical equipment, other than wheelchair
  • K0901

    Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
  • K0902

    Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
  • K0903

    For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each
  • K1001

    Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type   Discontinued
  • K1002

    Cranial electrotherapy stimulation (ces) system, any type   Discontinued
  • K1003

    Whirlpool tub, walk-in, portable   Discontinued
  • K1004

    Low frequency ultrasonic diathermy treatment device for home use
  • K1005

    Disposable collection and storage bag for breast milk, any size, any type, each   Discontinued
  • K1006

    Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system   Discontinued
  • K1007

    Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors
  • K1009

    Speech volume modulation system, any type, including all components and accessories   Discontinued
  • K1010

    Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each
  • K1011

    Activation device for intraurethral drainage device with valve, replacement only, each
  • K1012

    Charger and base station for intraurethral activation device, replacement only