K0071 Front Caster Assembly HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS K0071: Front Caster Assembly with Pneumatic Tire, Replacement

HCPCS Level II code K0071 covers a complete front caster assembly with a pneumatic tire, billed as a replacement part for mobility devices such as wheelchairs. This component-level code matters nationally because replacement parts are frequently billed across durable medical equipment (DME) suppliers, influencing supply-chain cost, repair turnaround, and beneficiary mobility. Coverage and payment policies for replacement parts can affect access to timely repairs and overall DME program spending.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes common coverage approaches, typical billing practices, and where policy variation is most likely to occur across commercial and government payers.

Readers will find: an overview of what K0071 represents clinically and operationally; typical sites of service and service type context for billing teams; summaries of payer coverage frameworks and common modifiers used in claims; and benchmarking topics relevant to DME replacement parts, including authorization patterns and claim denials. Where input data is missing, the text notes that specific details are not available. The focus is national in scope and aimed at billing managers, DME suppliers, and policy analysts seeking concise guidance on the code's usage and the policy issues that commonly surround replacement-part billing.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareK0071HCPCS Level IIdurable medical equipmentwheelchair partsreplacement assemblyDME billingmobility devicepayer policymedical billing

Billing Code Overview

HCPCS Level II code K0071 describes a front caster assembly, complete, with pneumatic tire, replacement only, each. This item is a replacement mobility device component intended for use on wheelchairs or similar assistive devices. Service type: Durable Medical Equipment — replacement part.

Typical site of service: Durable medical equipment supplier, outpatient clinic, or home delivery/installation depending on procurement and repair workflows.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A patient who uses a manual or power wheelchair presents to an orthotics/ prosthetics (O&P) clinic or durable medical equipment (DME) vendor because the front caster assembly with pneumatic tire on their wheelchair is damaged, worn, or nonfunctional. The typical patient is ambulatory-impaired with mobility needs due to neurologic, musculoskeletal, or age-related conditions and requires a functioning caster for safe maneuvering. The clinical workflow includes an initial assessment by an O&P clinician or DME technician to confirm the need for replacement, verification of wheelchair make/model and part compatibility, ordering the replacement part (K0071) billed as a HCPCS Level II supply, receipt of the replacement part, and either in-clinic or in-home installation and functional check. Documentation includes patient identifier, wheelchair serial number, description of damage, medical necessity statement linking the replacement to safe mobility, itemized part number K0071, date of service, and any service provided during installation (time and labor) and applicable modifier(s). Typical site of service is an O&P clinic, DME supplier location, or patient residence for durable medical equipment installation and repair.

Coding Specifications

Modifier	Description	When to Use
`52`	Reduced services

HCPCS K0043: Footrest Lower Extension Tube, Replacement

HCPCS-K0842-POWER-WHEELCHAIR-GROUP-2-CAPTAINS-CHAIR-300LBS

HCPCS K0842: Power Wheelchair Group 2, Captain's Chair, ≤300 lb

HCPCS-K0870-POWER-WHEELCHAIR-HEAVY-DUTY-301-450-LB-CAPACITY

HCPCS K0870: Power Wheelchair, Heavy Duty, 301–450 lb

HCPCS-K0848-POWER-WHEELCHAIR-GROUP-3-STANDARD-300LB-CAPACITY

HCPCS Level II K0848: Power Wheelchair Group 3, Sling/Solid Seat, 300 lb Capacity

HCPCS-K0462-TEMPORARY-REPLACEMENT-PATIENT-OWNED-EQUIPMENT-REPAIR

HCPCS K0462: Temporary Replacement for Patient-Owned Equipment Being Repaired

HCPCS-K0825-POWER-WHEELCHAIR-HEAVY-DUTY-301-450-LB-CAPACITY

HCPCS K0825: Power Wheelchair, Group 2 Heavy Duty, 301–450 lb Capacity

HCPCS-K0864-POWER-WHEELCHAIR-EXTRA-HEAVY-DUTY-601LBS-PLUS

HCPCS Level II K0864: Power Wheelchair, Extra Heavy Duty, 601+ lbs

HCPCS-K0843-POWER-WHEELCHAIR-HEAVY-DUTY-301-450-LBS

HCPCS K0843: Power Wheelchair, Heavy Duty, 301–450 lb Capacity

HCPCS-K0019-ARM-PAD-REPLACEMENT

HCPCS K0019: Arm Pad, Replacement Only, Each

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

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

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Taxonomy Code	Specialty	Notes
`334U00000X`	Orthotics & Prosthetics	Clinicians who assess and fit mobility devices and parts.
`3336C0003X`	Durable Medical Equipment	Suppliers specialized in DME product provision and installation.
`2084P0800X`	Physical Medicine & Rehabilitation	Physicians who may order and oversee durable medical equipment for mobility.
`261QM0800X`	Physical Therapist	Therapists who evaluate mobility needs and recommend equipment adjustments.
`224100000X`	Occupational Therapist	Clinicians who assess functional mobility and prescribe wheelchair modifications.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M19.90`	Osteoarthritis, unspecified site, unspecified	Degenerative joint disease leading to decreased mobility and increased reliance on wheelchair; caster replacement supports safe mobility.
`G82.50`	Paraplegia, unspecified, lower limb involvement, unspecified	Neurologic impairment requiring wheelchair use; maintenance and replacement of components like `K0071` are essential for function.
`G82.20`	Paraplegia, unspecified	Wheelchair-dependent patients often need replacement parts due to wear or damage.
`M62.81`	Muscle weakness (generalized)	Weakness can necessitate consistent wheelchair use; part failures compromise safety.
`M54.5`	Low back pain	Chronic pain can limit transfers and increase reliance on wheelchair; functional equipment maintenance is required.
`R26.2`	Difficulty in walking, not elsewhere classified	Patients with gait impairment who use wheelchairs require functioning casters for mobility.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Used when a clinician documents the evaluation and medical necessity for the caster replacement during an outpatient visit.
`97530`	Therapeutic activities, direct (one-on-one) patient contact by the provider, each 15 minutes	May be used by therapists for functional mobility training after installation of the new caster.
`99503`	Home visit for DME installation (non-specific home service code for supplier activities)	Used when the supplier performs in-home installation and checks of the replacement caster (note: exact CPT may vary by payer; suppliers often bill HCPCS for parts and use applicable service codes per payer).
`99070`	Supplies and materials (except spectacles), used by the physician or other qualified health care professional, which are not usually included with the office visit	Used to report additional supplies or small parts used during installation that are not included with `K0071`.
`99000`	Handling and/or conveyance of specimen for transfer from patient to laboratory	Not typically applicable; included here as a placeholder when institutional supply handling policies require adjunct service codes.

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