K0077 Front Caster Assembly Reimbursement | OpenPayer

Summary & Overview

HCPCS K0077: Front Caster Assembly with Solid Tire, Replacement

HCPCS Level II code K0077 identifies a complete front caster assembly with a solid tire intended for replacement on durable medical equipment, such as wheelchairs. Nationally, this code matters because correct coding of replacement components affects device functionality, supplier billing, and Medicare and commercial payer coverage determinations. Accurate use of K0077 supports appropriate reimbursement for suppliers and ensures patients receive timely repair or replacement of mobility device parts.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for this replacement part, common sites of service where the item is procured or installed, and the payer landscape relevant to claims submission. The report outlines benchmarks for coding practice and typical utilization patterns where available, notes policy considerations that affect coverage and billing, and lists common modifiers applicable to equipment components. Data not available in the input is identified explicitly when relevant.

This summary is intended for billing managers, durable medical equipment suppliers, clinical service coordinators, and policy analysts seeking a national perspective on coding and billing considerations for mobility device component replacement.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareK0077HCPCS Level IIdurable medical equipmentmobility deviceswheelchair partsequipment replacementbillingmedical coding

Billing Code Overview

HCPCS Level II code K0077 describes a front caster assembly, complete, with solid tire, replacement only, each. This item is a replacement front caster assembly intended for use on durable medical equipment such as wheelchairs or other mobility devices.

Service type: Durable medical equipment component replacement
Typical site of service: Durable medical equipment supplier, outpatient equipment repair shop, or clinical settings where mobility devices are serviced

Clinical & Coding Specifications

Clinical Context

A patient presents to a durable medical equipment (DME) vendor or wheelchair repair clinic after reporting instability and impaired steering of a manual or power wheelchair due to a damaged front caster assembly. The device technician evaluates the wheelchair, confirms wear or breakage of the front caster assembly with a solid tire, documents the need for a replacement part, and orders the replacement of one front caster assembly (billing code K0077) as a standalone supply. Typical workflow: intake and functional assessment by a DME technician; inspection and photo documentation of the damaged caster; verification of wheelchair make, model, and measurements; determination that a complete front caster assembly with a solid tire is required; procurement of the correct replacement part; replacement performed on-site or at the repair facility; final functional check and patient education on safe operation. Typical site of service is a DME supplier location, wheelchair repair shop, or outpatient rehabilitation equipment service area. A common patient scenario is an adult wheelchair user with long-term mobility impairment (e.g., post-spinal cord injury or progressive neurologic disease) who needs a single caster replacement to restore safe mobility and prevent falls or further frame damage.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier	Default when no specific modifier applies to the supply billing.

HCPCS K0002: Standard Hemi (Low Seat) Wheelchair

HCPCS-K0050-RATCHET-ASSEMBLY-REPLACEMENT

HCPCS K0050: Ratchet Assembly, Replacement Only

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

HCPCS K0853: Power Wheelchair, Very Heavy Duty Captains Chair

HCPCS-K0108-WHEELCHAIR-COMPONENT-ACCESSORY-NOS

HCPCS K0108: Wheelchair Component or Accessory, NOS

HCPCS-K0900-CUSTOMIZED-DURABLE-MEDICAL-EQUIPMENT

HCPCS K0900: Customized Durable Medical Equipment, Non-Wheelchair

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

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

HCPCS-K0040-ADJUSTABLE-ANGLE-FOOTPLATE

HCPCS K0040: Adjustable Angle Footplate, Each

HCPCS-K0007-EXTRA-HEAVY-DUTY-WHEELCHAIR

HCPCS K0007: Extra Heavy Duty Wheelchair

HCPCS-K0823-POWER-WHEELCHAIR-GROUP-2-CAPTAINS-CHAIR-300LB

HCPCS K0823: Power Wheelchair Group 2, Captain's Chair (≤300 lb)

HCPCS-K0601-REPLACEMENT-BATTERY-EXTERNAL-INFUSION-PUMP-1-5V

HCPCS K0601: Replacement Battery for External Infusion Pump, 1.5V

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Taxonomy Code	Specialty	Notes
`174500000X`	Durable Medical Equipment Supplier	Primary provider type performing caster replacement and DME billing.
`332B00000X`	Prosthetics & Orthotics	Providers who may fit and adjust wheelchair components.
`261QM0800X`	Physical Medicine & Rehabilitation	Clinicians overseeing wheelchair safety and authorizing repairs.
`207K00000X`	Orthopedic Surgery	Surgeons who may request or authorize equipment replacement after surgical patients' mobility changes.
`363L00000X`	Occupational Therapy	Therapists who identify the need for equipment repair during functional assessments.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M62.81`	Muscle weakness (generalized)	Mobility impairment leading to increased wear on wheelchair components and need for repairs.
`G82.20`	Paraplegia, unspecified	Common underlying condition for long-term wheelchair use; replacement of caster assemblies is routine maintenance.
`G82.50`	Quadriplegia, unspecified	Severe mobility impairment with high dependency on wheelchair integrity; caster replacement required for safe mobility.
`M21.8X9`	Other acquired deformities of limb, unspecified	Limb deformities can alter loading and increase caster wear.
`R26.89`	Other abnormalities of gait and mobility	Patients with gait/mobility disorders often use wheelchairs and require ongoing equipment maintenance.

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 occupational or physical therapists to assess functional mobility before or after the caster replacement.
`97542`	Wheelchair management (e.g., assessment, fitting, training), each 15 minutes	Commonly performed alongside caster replacement to assess seating, mobility, and need for adjustments.
`97035`	Ultrasound therapy, each 15 minutes	Occasionally used in associated clinical care but not directly related to the caster replacement; included when patients have soft-tissue concerns evaluated before mobility tasks.
`99070`	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit	Used when billing for non-routine supplies or special materials related to repair when payor allows.
`A9270`	Non-covered item or service E1399 (misc DME supply) — used by some payors for miscellaneous wheelchair parts	Used when the specific manufacturer part is billed differently; assists in claims coordination when `K0077` is not accepted by a payor.

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