Summary & Overview
HCPCS Level II K0824: Power Wheelchair, Heavy Duty 301–450 lb
HCPCS Level II code K0824 designates a group 2 heavy-duty power wheelchair with a sling/solid seat and back and a patient weight capacity of 301 to 450 pounds. This code identifies a class of durable medical equipment (DME) critical for mobility and independence among individuals with significant body-weight needs or mobility impairments. Nationally, appropriate coding ensures access to medically necessary mobility devices and supports accurate claims processing and utilization management for payers and suppliers.
Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for the device, typical sites of service where the device is used, and the role of K0824 in billing and coverage workflows. The publication also highlights typical policy considerations and benchmarks relevant to power mobility devices, common modifiers and billing practices (listed separately), and where to look for additional documentation or policy language.
This summary is intended for billing professionals, DME suppliers, clinical staff involved in mobility assessments, and policy analysts reviewing coverage criteria and claims submission processes. Data not available in the input are explicitly noted where applicable.
Billing Code Overview
HCPCS Level II code K0824 describes a power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds. This item is a durable medical equipment (DME) mobility device designed for patients who require power-operated wheelchairs with higher weight capacity and heavy-duty components.
Service type: Durable Medical Equipment — Power Mobility Device
Typical site of service: Home, outpatient medical equipment suppliers, long-term care facilities
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with morbid obesity (BMI 42 kg/m2), end-stage osteoarthritis of both knees, and chronic ischemic peripheral neuropathy presents for durable medical equipment evaluation for mobility assistance. The patient requires a power wheelchair with a weight capacity exceeding standard frames due to his body habitus and needs a stable, heavy-duty base with a sling/solid seat and back for pressure distribution and ease of transfers. A licensed physical therapist performs a mobility evaluation documenting inability to safely ambulate in the community or use a standard manual wheelchair, caregiver limitations, and measurements (seat width, depth) confirming need for a heavy-duty Group 2 power wheelchair.
The clinical workflow includes: referral from the primary care physician or physiatrist; a face-to-face mobility assessment by a qualified supplier or therapist; documentation of functional limitations, home environment, and trial of alternative devices; specification of the power wheelchair: K0824 (group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds); prior authorization submission to the payer with supporting clinical notes and measurements; delivery, fitting, training, and final documentation of medical necessity and usage.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no additional modifier applies |