K0047 HCPCS: Reimbursement & Policy Benchmarks | OpenPayer

Summary & Overview

HCPCS K0047: Elevating Legrest Upper Hanger Bracket, Replacement

HCPCS Level II code K0047 denotes an elevating legrest upper hanger bracket supplied as a replacement component for durable medical equipment. As a HCPCS Level II supply code, K0047 is used when replacing a specific mechanical part of a mobility or seating system rather than billing for a complete device. Nationally, accurate coding for replacement parts matters for correct claims processing, supply chain tracking, and continuity of durable medical equipment services.

Key payers in this national overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical and billing context for K0047, what sites of service typically use this code, and what to expect in terms of documentation and claim classification. The publication also outlines common benchmarks and policy-relevant considerations for replacement part codes, summarizes relevant billing practices, and highlights areas where payers often provide guidance or require specific documentation.

This summary is intended to orient billing professionals, durable medical equipment suppliers, and policy analysts to the role of HCPCS Level II code K0047 in claims workflows and payer interactions at a national level.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareK0047HCPCS Level IIdurable medical equipmentreplacement partmobility devicelegrestmedical suppliesbilling

Billing Code Overview

HCPCS Level II code K0047 describes an elevating legrest, upper hanger bracket, replacement only, each. This item is a durable medical equipment component intended to replace the upper hanger bracket used to support an elevating legrest on a mobility device or seating system.

Service type: Durable medical equipment replacement part
Typical site of service: Durable medical equipment suppliers, outpatient medical equipment service locations, and patient home when installed as part of a home medical device

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

Clinical & Coding Specifications

Clinical Context

A patient who uses a manual or power wheelchair presents to durable medical equipment (DME) repair services because the existing elevating legrest hanger bracket has fractured or its mounting hardware has failed, making the legrest inoperable. Typical patients include individuals with lower-extremity weakness, spasticity, amputation, or chronic venous/lymphatic conditions who rely on an elevating legrest for pressure redistribution, edema control, or foot clearance. The clinical workflow: a DME technician or allied health professional inspects the wheelchair either in an outpatient clinic, home visit, or DME repair shop; documents the broken upper hanger bracket and determines that only the replacement component is required (no full wheelchair replacement). The technician orders the component billed under K0047 (elevating legrest, upper hanger bracket, replacement only, each), obtains patient and payor information (for example, Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, Medicare), and schedules the repair. The technician installs the replacement bracket, tests legrest movement and secure attachment, records the component serial/manufacturer numbers, documents the procedure and medical necessity tied to the patient’s diagnosis, collects required signatures, and submits the claim with appropriate modifiers and diagnosis linkage. Typical sites of service are DME supplier shops, outpatient DME clinics, or patient homes during DME repair visits.

Coding Specifications

Modifier	Description	When to Use
`52`

HCPCS K0820: Power Wheelchair Group 2 Portable, Up to 300 lb

HCPCS-K0869-POWER-WHEELCHAIR-GROUP-4-CAPTAINS-CHAIR-300LB-CAPACITY

HCPCS K0869: Power Wheelchair Group 4, Captain's Chair, ≤300 lb

HCPCS-K0195-ELEVATING-LEG-RESTS-WHEELCHAIR-ACCESSORY

HCPCS K0195: Elevating Leg Rests for Wheelchair Base

HCPCS-K0072-FRONT-CASTER-ASSEMBLY-SEMI-PNEUMATIC-TIRE-REPLACEMENT

HCPCS K0072: Front Caster Assembly with Semi-Pneumatic Tire, Replacement Only

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

HCPCS K0037: High Mount Flip-Up Footrest, Each

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

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

HCPCS-K0669-WHEELCHAIR-SEAT-BACK-CUSHION-UNCLASSIFIED

HCPCS K0669: Wheelchair Seat or Back Cushion, Unclassified

HCPCS-K0019-ARM-PAD-REPLACEMENT

HCPCS K0019: Arm Pad, Replacement Only, Each

HCPCS-K0808-POWER-OPERATED-VEHICLE-VERY-HEAVY-DUTY-451-600-LB

HCPCS K0808: Power Operated Vehicle, Very Heavy Duty (451–600 lb)

HCPCS-K0006-HEAVY-DUTY-WHEELCHAIR

HCPCS Level II K0006: Heavy Duty Wheelchair

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Taxonomy Code	Specialty	Notes
Data not available in the input.	Please see below common specialties derived from clinical practice	Use the most appropriate taxonomy when submitting claims
`261QM0800X`	Physical Medicine & Rehabilitation	Clinicians who assess mobility needs and request DME repairs.
`251S00000X`	Medical Equipment Supplier	Suppliers and DME technicians who perform repairs and replacements.
`207L00000X`	Orthotics & Prosthetics	Specialists who may manage wheelchair components and fittings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M62.81`	Muscle weakness (generalized)	Patients with lower-extremity weakness commonly require elevating legrests for support and protection; bracket failure necessitates replacement.
`I83.90`	Varicose veins of lower extremities without ulcer or inflammation, unspecified	Chronic venous insufficiency and edema may require leg elevation; functional need for an elevating legrest links the diagnosis to the repair.
`L97.909`	Non-pressure chronic ulcer of unspecified part of lower leg, unspecified severity	Wounds or ulcers that benefit from leg elevation for edema reduction and offloading may lead to reliance on a functioning elevating legrest.
`Z96.641`	Presence of right artificial knee joint	Amputations or joint replacements that alter limb positioning can increase dependence on legrest components.
`G82.20`	Paraplegia, unspecified	Patients with paralysis frequently use specialized seating and elevating legrests; component failure requires timely replacement.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99070`	Supplies and materials (e.g., bandages, gloves), used during patient care, not included in service	Used to bill incidental supplies or small parts used during the repair visit if the payer allows.
`97760`	Orthotic(s) management and training; initial encounter	May be used when additional orthotic management or patient training accompanies the replacement of wheelchair components.
`99080`	Special reports and documents; completion of medical documentation	Use when payers require detailed documentation or special reporting for DME repairs (billing varies by payer).
`A9270`	Non-covered item or service	Use only for reporting non-covered components when required by payer guidance (not a CPT but HCPCS: included here as commonly associated).
`T1013`	Patient-education, non-physician provider, per diem	Use when patient/caregiver education on safe wheelchair use is provided following the repair (billing per payer policy).

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