K0045 Footrest Replacement HCPCS: Reimbursement | OpenPayer

Summary & Overview

HCPCS Level II K0045: Footrest, Complete Assembly, Replacement

HCPCS Level II code K0045 denotes a replacement footrest, complete assembly for durable medical equipment, reflecting a routine yet essential component for patient seating and mobility support. Nationally, accurate coding for replacement parts like K0045 affects durable medical equipment workflows, inventory management, and claim adjudication across public and private payers. Coverage and payment policies for replacement components can influence patient access to functional seating and mobility solutions.

Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how K0045 is categorized and used clinically, summaries of payer coverage approaches, common billing and documentation considerations, and comparisons of reimbursement handling where available. The publication also outlines relevant policy updates and claims-processing themes that affect replacement DME components.

This summary is intended for clinicians, billing professionals, and policy analysts seeking a national-level reference on the clinical role and payer handling of a replacement footrest assembly billed under HCPCS Level II code K0045.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareK0045HCPCS Level IIdurable medical equipmentDME replacement partmobility aidsseating componentsmedical billingclaims processing

Billing Code Overview

HCPCS Level II code K0045 describes a footrest, complete assembly, replacement only, each. This item is a component of durable medical equipment intended to provide support and positioning for a patient’s lower extremities.

Service type: Durable medical equipment (replacement part)
Typical site of service: Durable medical equipment used in ambulatory settings, home, long-term care, or other sites where mobility or seating support is provided

Clinical & Coding Specifications

Clinical Context

A patient receiving durable medical equipment for a wheelchair requires replacement of a complete footrest assembly. Typical scenario: a 68-year-old patient with chronic stroke-related hemiparesis has an existing manual wheelchair whose footrest is worn, broken, or lost, causing impaired foot support and risk of pressure injury. The durable medical equipment (DME) supplier documents medical necessity, verifies the original wheelchair make/model, and orders the replacement footrest assembly described by K0045. The workflow includes verification of patient identity and payer coverage, collecting clinical information from the treating clinician (e.g., physical therapist or rehabilitation physician) describing the need for replacement, confirming measurements or compatibility, obtaining prior authorization if required by the payor, and scheduling delivery and fitting. The supplier records the product serial number, documents that only the replacement part (not a new wheelchair) is provided, obtains the patient’s signature on delivery, and bills the payor using K0045 with appropriate modifier(s) to reflect bilateral LT/RT or other payer-required information.

Coding Specifications

Modifier	Description	When to Use
`LT`

HCPCS K0020: Fixed, Adjustable Height Armrest, Pair

HCPCS-K0861-POWER-WHEELCHAIR-GROUP-3-STANDARD-300LBS

HCPCS K0861: Power Wheelchair Group 3 Standard, 300 lb Capacity

HCPCS-K0835-POWER-WHEELCHAIR-GROUP-2-STANDARD-300LB-CAPACITY

HCPCS K0835: Power Wheelchair Group 2 Standard, 300 lb Capacity

HCPCS-K0891-POWER-WHEELCHAIR-GROUP-5-PEDIATRIC

HCPCS K0891: Power Wheelchair Group 5 Pediatric, Up to 125 lb

HCPCS-K0860-POWER-WHEELCHAIR-VERY-HEAVY-DUTY-451-600-LB

HCPCS K0860: Power Wheelchair, Very Heavy Duty, 451–600 lb

HCPCS-K0105-IV-HANGER-INFUSION-SUPPLY

HCPCS K0105: IV Hanger, Each

HCPCS-K0853-POWER-WHEELCHAIR-VERY-HEAVY-DUTY-CAPTAINS-CHAIR-451-600LBS

HCPCS K0853: Power Wheelchair, Very Heavy Duty Captains Chair

HCPCS-K0850-POWER-WHEELCHAIR-GROUP-3-HEAVY-DUTY-301-450-LB

HCPCS K0850: Power Wheelchair Group 3 Heavy Duty, 301–450 lb

HCPCS-K0672-LOWER-EXTREMITY-ORTHOSIS-REMOVABLE-SOFT-INTERFACE-REPLACEMENT

HCPCS K0672: Lower Extremity Orthosis Removable Soft Interface, Replacement

HCPCS-K0037-HIGH-MOUNT-FLIP-UP-FOOTREST

HCPCS K0037: High Mount Flip-Up Footrest, Each

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Taxonomy Code	Specialty	Notes
`207Q00000X`	Physical Medicine & Rehabilitation Physician	Often documents medical necessity and prescribes wheelchair component replacement.
`261QM0800X`	Physical Therapist	Performs assessment and documents functional need and measurements for the footrest.
`3336C0002X`	Durable Medical Equipment Supplier	Supplier responsible for providing and fitting `K0045` (common taxonomy for DME suppliers varies by organization).
`207L00000X`	Physical Therapist Assistant	Assists with fitting and follow-up evaluation.
`364S00000X`	Occupational Therapist	Documents need for foot support and activities of daily living impact.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M62.81`	Muscle weakness (generalized)	Weakness may necessitate wheelchair use and footrest replacement for positioning and support.
`I69.351`	Hemiplegia and hemiparesis following cerebral infarction, right dominant side	Patients with post-stroke hemiparesis commonly use wheelchairs requiring footrest components.
`I69.352`	Hemiplegia and hemiparesis following cerebral infarction, left dominant side	As above for left-sided weakness.
`G82.20`	Paraplegia, unspecified	Long-term wheelchair users with paraplegia frequently require replacement parts like footrests.
`G82.50`	Quadriplegia, unspecified	High-level spinal cord injury patients depend on properly fitting footrests for lower-limb support.
`M54.16`	Radiculopathy, lumbar region	Lower-extremity radicular pain may lead to mobility limitations and wheelchair use where footrest replacement is needed.
`R26.2`	Difficulty in walking, not elsewhere classified	Progressive mobility impairment prompting wheelchair dependence and component replacement.
`Z99.3`	Dependence on wheelchair	Directly supports medical necessity for wheelchair components such as `K0045`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97530`	Therapeutic activities, direct one-on-one patient contact by the provider, each 15 minutes	Performed by physical or occupational therapists to train safe transfers and use of the replaced footrest assembly.
`97112`	Neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and proprioception	Used when therapists address gait, positioning, or balance affected by foot support changes after installation.
`97110`	Therapeutic exercises to develop strength and endurance, range of motion and flexibility	May be used pre- or post-fitting to improve lower-extremity function in wheelchair users.
`99070`	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or procedure	Used if a clinician supplies minor DME items during clinic visits; generally separate from DME supplier billing.
`A9270`	Non-covered item or service (not otherwise classified) — HCPCS Level III	Included here only as cross-reference; not a primary billing code for standard footrest replacement but may appear in certain payer adjudications.

If additional CPT codes are required for surgical procedures related to foot/leg interventions, they should be selected per clinical context and payer rules. Use supplier and therapy billing conventions when coordinating K0045 replacement with therapy services.

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