Summary & Overview
HCPCS K0839: Very Heavy Duty Power Wheelchair, 451–600 lb Capacity
HCPCS Level II code K0839 denotes a very heavy-duty group 2 power wheelchair with a single power option and a sling or solid seat/back designed for patients weighing 451 to 600 pounds. This equipment classification matters nationally because it addresses mobility needs for individuals with high weight capacities and higher durability requirements, affecting durable medical equipment (DME) coverage, clinical mobility planning, and supply chain provisioning.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical meaning and typical sites of service, payer coverage considerations, and areas where benchmarks and policy updates commonly impact reimbursement and utilization. The publication outlines common modifiers and operational considerations used with HCPCS Level II billing, and highlights clinical contexts in which this equipment is typically prescribed.
The content provides practical reference material for billing teams, DME suppliers, and clinical staff responsible for mobility assessments, without offering clinical guidance. Data not available in the input is stated where applicable; national payers and common modifier lists are included to assist in administrative planning and claims submission workflows.
Billing Code Overview
HCPCS Level II code K0839 describes a power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds. This item is a durable medical equipment mobility device intended for individuals requiring a very heavy-duty power wheelchair to support higher body weight.
Service Type: Durable medical equipment — power mobility device
Typical Site of Service: Home, long-term care facility, or other outpatient settings where durable medical equipment is used
Clinical & Coding Specifications
Clinical Context
A 68-year-old male patient with morbid obesity (body weight 525 pounds) and progressive lower-extremity weakness from longstanding diabetic peripheral neuropathy and osteoarthritis requires a power wheelchair with very heavy duty capacity. The durable medical equipment (DME) supplier receives a physician order specifying a power wheelchair, group 2 very heavy duty, single power option, sling/solid seat and back with declared patient weight capacity 451–600 pounds (K0839). The clinical workflow includes: a physician or rehabilitation specialist documents medical necessity (functional limitations, mobility assessment, home environment), the supplier performs a face-to-face assessment and seating evaluation, prior authorization is obtained from the patient’s insurer when required, the device is fabricated or configured to the patient’s measurements and weight rating, delivery and in-home setup occur with training for the patient and caregiver, and follow-up is scheduled for adjustments and maintenance. Typical sites of service are the patient’s home or a DME supplier facility for evaluation and delivery. Payors involved may include Medicare, Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and commercial plans such as BUCA.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side (not in provided list) | Data not available in the input. |