| K0001 |
Standard wheelchair |
| K0002 |
Stnd hemi (low seat) whlchr |
| K0003 |
Lightweight wheelchair |
| K0004 |
High strength ltwt whlchr |
| K0005 |
Ultralightweight wheelchair |
| K0006 |
Heavy duty wheelchair |
| K0007 |
Extra heavy duty wheelchair |
| K0008 |
Cstm manual wheelchair/base |
| K0009 |
Other manual wheelchair/base |
| K0010 |
Stnd wt frame power whlchr |
| K0011 |
Stnd wt pwr whlchr w control |
| K0012 |
Ltwt portbl power whlchr |
| K0013 |
Custom power whlchr base |
| K0014 |
Other power whlchr base |
| K0015 |
Detach non-adj ht armrst rep |
| K0017 |
Detach adjust armrest base |
| K0018 |
Detach adjust armrst upper |
| K0019 |
Arm pad repl, each |
| K0020 |
Fixed adjust armrest pair |
| K0037 |
Hi mount flip-up footrest ea |
| K0038 |
Leg strap each |
| K0039 |
Leg strap h style each |
| K0040 |
Adjustable angle footplate |
| K0041 |
Large size footplate each |
| K0042 |
Standard size ftplate rep ea |
| K0043 |
Ftrst lowr exten tube rep ea |
| K0044 |
Ftrst upr hanger brac rep ea |
| K0045 |
Ftrst compl assembly repl ea |
| K0046 |
Elev lgrst lwr exten repl ea |
| K0047 |
Elev legrst upr hangr rep ea |
| K0050 |
Ratchet assembly replacement |
| K0051 |
Cam rel asm ft/legrst rep ea |
| K0052 |
Swingaway detach ftrest repl |
| K0053 |
Elevate footrest articulate |
| K0056 |
Seat ht <17 or >=21 ltwt wc |
| K0065 |
Spoke protectors |
| K0069 |
Rr whl compl sol tire rep ea |
| K0070 |
Rr whl compl pne tire rep ea |
| K0071 |
Fr cstr comp pne tire rep ea |
| K0072 |
Fr cstr semi-pne tire rep ea |
| K0073 |
Caster pin lock each |
| K0077 |
Fr cstr asmb sol tire rep ea |
| K0098 |
Drive belt for pwc, repl |
| K0105 |
Iv hanger |
| K0108 |
W/c component-accessory nos |
| K0195 |
Elevating whlchair leg rests |
| K0455 |
Pump uninterrupted infusion |
| K0462 |
Temporary replacement eqpmnt |
| K0552 |
Sup/ext non-ins inf pump syr |
| K0553 |
Ther cgm supply allowance |
| K0554 |
Ther cgm receiver/monitor |
| K0601 |
Repl batt silver oxide 1.5 v |
| K0602 |
Repl batt silver oxide 3 v |
| K0603 |
Repl batt alkaline 1.5 v |
| K0604 |
Repl batt lithium 3.6 v |
| K0605 |
Repl batt lithium 4.5 v |
| K0606 |
Aed garment w elec analysis |
| K0607 |
Repl batt for aed |
| K0608 |
Repl garment for aed |
| K0609 |
Repl electrode for aed |
| K0669 |
Seat/back cus no dmepdac ver |
| K0672 |
Removable soft interface le |
| K0730 |
Ctrl dose inh drug deliv sys |
| K0733 |
12-24hr sealed lead acid |
| K0738 |
Portable gas oxygen system |
| K0739 |
Repair/svc dme non-oxygen eq |
| K0740 |
Repair/svc oxygen equipment |
| K0743 |
Portable home suction pump |
| K0744 |
Absorp drg <= 16 suc pump |
| K0745 |
Absorp drg >16<=48 suc pump |
| K0746 |
Absorp drg >48 suc pump |
| K0800 |
Pov group 1 std up to 300lbs |
| K0801 |
Pov group 1 hd 301-450 lbs |
| K0802 |
Pov group 1 vhd 451-600 lbs |
| K0806 |
Pov group 2 std up to 300lbs |
| K0807 |
Pov group 2 hd 301-450 lbs |
| K0808 |
Pov group 2 vhd 451-600 lbs |
| K0812 |
Power operated vehicle noc |
| K0813 |
Pwc gp 1 std port seat/back |
| K0814 |
Pwc gp 1 std port cap chair |
| K0815 |
Pwc gp 1 std seat/back |
| K0816 |
Pwc gp 1 std cap chair |
| K0820 |
Pwc gp 2 std port seat/back |
| K0821 |
Pwc gp 2 std port cap chair |
| K0822 |
Pwc gp 2 std seat/back |
| K0823 |
Pwc gp 2 std cap chair |
| K0824 |
Pwc gp 2 hd seat/back |
| K0825 |
Pwc gp 2 hd cap chair |
| K0826 |
Pwc gp 2 vhd seat/back |
| K0827 |
Pwc gp vhd cap chair |
| K0828 |
Pwc gp 2 xtra hd seat/back |
| K0829 |
Pwc gp 2 xtra hd cap chair |
| K0830 |
Pwc gp2 std seat elevate s/b |
| K0831 |
Pwc gp2 std seat elevate cap |
| K0835 |
Pwc gp2 std sing pow opt s/b |
| K0836 |
Pwc gp2 std sing pow opt cap |
| K0837 |
Pwc gp 2 hd sing pow opt s/b |
| K0838 |
Pwc gp 2 hd sing pow opt cap |
| K0839 |
Pwc gp2 vhd sing pow opt s/b |
| K0840 |
Pwc gp2 xhd sing pow opt s/b |
| K0841 |
Pwc gp2 std mult pow opt s/b |
| K0842 |
Pwc gp2 std mult pow opt cap |
| K0843 |
Pwc gp2 hd mult pow opt s/b |
| K0848 |
Pwc gp 3 std seat/back |
| K0849 |
Pwc gp 3 std cap chair |
| K0850 |
Pwc gp 3 hd seat/back |
| K0851 |
Pwc gp 3 hd cap chair |
| K0852 |
Pwc gp 3 vhd seat/back |
| K0853 |
Pwc gp 3 vhd cap chair |
| K0854 |
Pwc gp 3 xhd seat/back |
| K0855 |
Pwc gp 3 xhd cap chair |
| K0856 |
Pwc gp3 std sing pow opt s/b |
| K0857 |
Pwc gp3 std sing pow opt cap |
| K0858 |
Pwc gp3 hd sing pow opt s/b |
| K0859 |
Pwc gp3 hd sing pow opt cap |
| K0860 |
Pwc gp3 vhd sing pow opt s/b |
| K0861 |
Pwc gp3 std mult pow opt s/b |
| K0862 |
Pwc gp3 hd mult pow opt s/b |
| K0863 |
Pwc gp3 vhd mult pow opt s/b |
| K0864 |
Pwc gp3 xhd mult pow opt s/b |
| K0868 |
Pwc gp 4 std seat/back |
| K0869 |
Pwc gp 4 std cap chair |
| K0870 |
Pwc gp 4 hd seat/back |
| K0871 |
Pwc gp 4 vhd seat/back |
| K0877 |
Pwc gp4 std sing pow opt s/b |
| K0878 |
Pwc gp4 std sing pow opt cap |
| K0879 |
Pwc gp4 hd sing pow opt s/b |
| K0880 |
Pwc gp4 vhd sing pow opt s/b |
| K0884 |
Pwc gp4 std mult pow opt s/b |
| K0885 |
Pwc gp4 std mult pow opt cap |
| K0886 |
Pwc gp4 hd mult pow s/b |
| K0890 |
Pwc gp5 ped sing pow opt s/b |
| K0891 |
Pwc gp5 ped mult pow opt s/b |
| K0898 |
Power wheelchair noc |
| K0899 |
Pow mobil dev no dmepdac |
| K0900 |
Cstm dme other than wheelchr |
| K1001 |
Electronic posa treatment |
| K1002 |
Ces system w/supplies access |
| K1003 |
Whirlpool tub walkin portabl |
| K1004 |
Lo freq us diathermy device |
| K1005 |
Disp col sto bag breast milk |