HCPCS K0015: Detachable Non-Adjustable Armrest, Replacement Only, Each - OpenPayer

Summary & Overview

HCPCS K0015: Detachable Non-Adjustable Armrest, Replacement Only, Each

HCPCS Level II code K0015 identifies a detachable, non-adjustable height armrest sold as a replacement part for durable medical seating equipment. Nationally, replacement components for mobility and seating aids are important for maintaining functional independence and ensuring safety for patients who rely on wheelchairs and similar devices. Coverage and billing practices for replacement parts can affect out-of-pocket costs and continuity of device use.

Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what K0015 represents, the clinical and equipment context for its use, and the typical settings where the item is provided. The publication also outlines payer coverage considerations and benchmarking topics readers can expect, including reimbursement patterns, claims coding guidance, and policy updates relevant to durable medical equipment replacement parts.

This summary is intended for clinicians, billing professionals, and policy analysts seeking a national perspective on billing and coverage for a common wheelchair armrest replacement component.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareK0015HCPCS Level IIdurable medical equipmentwheelchair accessoriesreplacement partsmedical billingDME policyoutpatient equipment

Billing Code Overview

HCPCS Level II code K0015 describes a detachable, non-adjustable height armrest, replacement only, each. This item represents a single replacement armrest component intended for use with seating equipment such as wheelchairs and other durable medical seating devices. The service type is durable medical equipment (DME) replacement part, and the typical site of service is outpatient or home use where durable medical equipment is maintained or repaired.

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Clinical & Coding Specifications

Clinical Context

A patient presents to an outpatient durable medical equipment (DME) supplier or an orthotics/rehab clinic requesting a replacement armrest for a wheelchair after wear or accidental damage. Typical patients include individuals with mobility impairments due to spinal cord injury, stroke with hemiparesis, osteoarthritis, or progressive neuromuscular disease who use a manual or power wheelchair with detachable, non-adjustable height armrests. Workflow: clinician or DME supplier documents the need, reviews the current wheelchair configuration, confirms the original equipment manufacturer (OEM) armrest type and that the armrest is detachable and non-adjustable height, obtains a signed order from the treating provider specifying replacement part K0015 (detachable, non-adjustable height armrest, replacement only, each), verifies payer coverage and medical necessity based on loss, damage, or safety/function issues, and dispenses the part. Typical sites of service are outpatient DME supplier locations, outpatient rehabilitation clinics, and home delivery by DME providers. Payer interactions commonly include Medicare (Durable Medical Equipment Medicare Administrative Contractor rules), Blue Cross Blue Shield, Aetna, Cigna Health, UnitedHealthcare, and BUCA plan adjudication for replacement parts and repair coverage.

Coding Specifications

Modifier	Description	When to Use
`52`	Reduced services	Use when only part of the original service is provided (e.g., minor repair that does not restore full original armrest function).

HCPCS Level II K0877: Power Wheelchair Group 4 Standard, 300 lb Capacity

HCPCS-K0854-POWER-WHEELCHAIR-EXTRA-HEAVY-DUTY-601LBS-PLUS

HCPCS K0854: Power Wheelchair Extra Heavy Duty, 601+ lb Capacity

HCPCS-K0900-CUSTOMIZED-DURABLE-MEDICAL-EQUIPMENT

HCPCS K0900: Customized Durable Medical Equipment, Non-Wheelchair

HCPCS-K0020-FIXED-ADJUSTABLE-HEIGHT-ARMREST-PAIR

HCPCS K0020: Fixed, Adjustable Height Armrest, Pair

HCPCS-K0073-CASTER-PIN-LOCK

HCPCS K0073: Caster Pin Lock, Each

HCPCS-K0838-POWER-WHEELCHAIR-HEAVY-DUTY-301-450LBS

HCPCS K0838: Power Wheelchair, Heavy Duty, 301–450 lb

HCPCS-K0047-ELEVATING-LEGREST-UPPER-HANGER-BRACKET-REPLACEMENT

HCPCS K0047: Elevating Legrest Upper Hanger Bracket, Replacement

HCPCS-K0008-CUSTOM-MANUAL-WHEELCHAIR

HCPCS Level II K0008: Custom Manual Wheelchair/Base

HCPCS-K0816-POWER-WHEELCHAIR-GROUP-1-CAPTAINS-CHAIR-300LBS

HCPCS K0816: Power Wheelchair Group 1, Captain's Chair, up to 300 lb

HCPCS-K0013-CUSTOM-MOTORIZED-POWER-WHEELCHAIR-BASE

HCPCS K0013: Custom Motorized/Power Wheelchair Base

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Taxonomy Code	Specialty	Notes
`261QM0800X`	Physical Medicine & Rehabilitation	Clinicians who assess mobility needs and authorize DME and replacement parts.
`261QG0400X`	Orthotics & Prosthetics	Specialists who fit and order wheelchair components and replacement armrests.
`2084P0200X`	Physical Therapist	Evaluates seating and mobility; documents need for replacement armrest to support function.
`251B00000X`	Durable Medical Equipment & Medical Supplies Supplier	DME suppliers who dispense `K0015` and manage billing and warranty issues.
`207R00000X`	Occupational Therapist	Assesses activities of daily living and documents requirements for armrest replacement.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G82.20`	Paraplegia, unspecified	Patients with paraplegia commonly use wheelchairs and require armrest replacement due to wear or damage.
`I69.351`	Hemiplegia and hemiparesis following cerebral infarction, right dominant side	Post-stroke patients with hemiparesis use armrests for support; replacements restore seating safety and function.
`M19.90`	Osteoarthritis, unspecified site	Advanced joint disease can limit transfers and stability; durable armrests maintain positioning and assist transfers.
`G12.21`	Amyotrophic lateral sclerosis	Progressive neuromuscular disease leads to long-term wheelchair use; replacement parts maintain independence and comfort.
`M62.81`	Muscle weakness (generalized)	Generalized weakness increases reliance on wheelchair armrests for support; replacement ensures continued function.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97530`	Therapeutic activities, direct (one-on-one) patient contact	Occupational therapy evaluation or treatment that may identify need for wheelchair armrest replacement due to functional limitations.
`97161`	Physical therapy evaluation, low complexity	PT evaluation that documents mobility impairment and need for DME replacement parts.
`97760`	Orthotic management and training	Services provided when fitting or adjusting wheelchair components, including armrests.
`99070`	Supplies and materials (except spectacles), non-covered items	Used by some suppliers when billing for non-covered ancillary items associated with DME; payer-specific.
`A9270`	Non-covered item or service	HCPCS Level II code often used by suppliers when an item is not covered; relevant when `K0015` is denied by payer (listed here for workflow context).

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