Summary & Overview
HCPCS K0842: Power Wheelchair Group 2, Captain's Chair, ≤300 lb
HCPCS Level II code K0842 denotes a Group 2 standard power wheelchair with multiple power options and a captain’s chair design, rated for patients up to and including 300 pounds. Nationally, this code identifies durable medical equipment (DME) used to support mobility and independence for individuals with substantial functional impairment. Its use affects durable medical equipment coverage, supplier billing practices, and mobility device provision across payer types.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of what K0842 represents clinically and operationally, typical sites of service, and the payer landscape for coverage and billing. The publication summarizes reimbursement benchmarks where available, common documentation and coverage considerations, and regulatory or policy updates that influence access to power mobility devices. Clinical context touches on the intended patient population and functional need for powered mobility.
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, related codes, or detailed payer-specific reimbursement amounts is noted. The piece provides a practical reference for clinicians, DME suppliers, and billing professionals seeking a national-level overview of HCPCS Level II code K0842.
Billing Code Overview
HCPCS Level II code K0842 describes a power wheelchair, group 2 standard, multiple power option, captain's chair, with patient weight capacity up to and including 300 pounds. This equipment is a motorized mobility device intended to provide mobility assistance for individuals with significant functional limitations who require a powered seating system.
Service type: Durable Medical Equipment (power mobility device)
Typical site of service: Home or community settings (outpatient/home durable medical equipment use, including home delivery and setup)
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with advanced Parkinson disease and significant mobility impairment is evaluated by a durable medical equipment (DME) specialist after multiple falls and progressive inability to ambulate safely in the community. The patient weighs 280 pounds and requires full power seating and drive controls. After a face-to-face evaluation by a physician and an assessment by a physical therapist documenting functional limitations, home environment barriers, and prior conservative interventions (walker, cane, and manual wheelchair) proving inadequate, the DME supplier orders a power wheelchair. The device ordered matches K0842 — a Group 2 standard power wheelchair with multiple power options and a captain’s chair, capacity up to and including 300 pounds.
The clinical workflow: the physician documents the medical necessity, diagnosis codes, mobility evaluation, and detailed justification for power seating and multiple power options. A physical or occupational therapist completes a mobility assessment and trial, recommending specific seating and control configurations. The DME supplier completes prior authorization with payors, coordinates delivery and seating analysis, and completes final fitting in the patient’s home. Follow-up includes training the patient/caregiver on operation and safe transfers, and documenting outcomes and any component adjustments for billing and warranty records.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |