Summary & Overview
HCPCS K0831: Power Wheelchair Group 2 with Seat Elevator, Captain's Chair
HCPCS Level II code K0831 identifies a Group 2 standard power wheelchair with a seat elevator and captain's chair configuration, rated for patients up to and including 300 pounds. This code matters nationally because power mobility devices are essential durable medical equipment that support independence, access to care, and participation in community life for individuals with mobility impairments. Coverage, coding, and supplier requirements for such devices affect clinical care pathways and cost management across public and private payers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what K0831 represents, typical service setting and clinical context, and the types of benchmarks and policy considerations commonly associated with power mobility device codes. The publication summarizes standard utilization contexts, common billing modifiers and processing issues (listed separately), and the relevance of device features—such as seat elevators and captain's chairs—to clinical need and coverage determinations.
The content is intended to inform coding professionals, durable medical equipment suppliers, and policy analysts about the clinical description, service classification, and payer landscape related to HCPCS Level II code K0831. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code K0831 describes a power wheelchair, group 2 standard, seat elevator, captain's chair, patient weight capacity up to and including 300 pounds. This equipment classification indicates a powered mobility device designed for individuals who require an electric wheelchair with a standard Group 2 drive and a built-in seat elevator mechanism to assist with vertical positioning. The reference to a captain's chair identifies a specific seat style with armrests and an integrated back, intended for seated comfort and support.
Service Type: Durable Medical Equipment — Power Mobility Device
Typical Site of Service: Home or community use, including private residences and community settings where the patient requires a power wheelchair for mobility and activities of daily living.
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Clinical & Coding Specifications
Clinical Context
A typical patient is a 72-year-old individual with advanced degenerative joint disease, spinal stenosis, or progressive neuromuscular weakness who requires a powered mobility device with a seat elevator and captain's chair to transfer safely and perform activities of daily living. The patient’s weight is within the device limit (up to and including 300 pounds). The clinical workflow begins with an evaluation by a physiatrist, occupational therapist, or wheelchair clinic specialist who documents mobility deficits, ADL limitations, home environment barriers, and prior conservative mobility aids tried (canes, walkers, manual wheelchair). A trial or demonstration of a Group 2 standard power wheelchair with a seat elevator is performed to assess fit, postural support, maneuverability, and transfer ergonomics. The clinician documents medical necessity, objective functional limitations, and prescribed options (captain’s chair, seat elevator) in the plan of care. A face-to-face or telehealth visit may generate a detailed prescription and justification for the power wheelchair. The durable medical equipment supplier verifies the prescription, conducts a home assessment when indicated, obtains payment authorization from the payer (e.g., Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, BUCA, Medicare), and schedules delivery, setup, and user training. Post-delivery, follow-up visits with therapy or the prescribing clinician document device use, any adjustments, and ongoing need or complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier |