HCPCS K0885: Power Wheelchair Group 4, Captain's Chair, 300 lb Capacity - OpenPayer

Summary & Overview

HCPCS K0885: Power Wheelchair Group 4, Captain's Chair, 300 lb Capacity

HCPCS Level II code K0885 denotes a Group 4 power wheelchair with multiple power options and a captain's chair configuration rated for patients up to and including 300 pounds. As a durable medical equipment code for complex power mobility devices, it is relevant to durable medical equipment benefit determinations, prior authorization reviews, and mobility management programs nationwide. Coverage and payment policies for such devices affect access to mobility for patients with significant functional limitations and have implications for home- and community-based care.

Key national payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what the code represents, typical sites of service, and the clinical context in which a Group 4 power wheelchair is used. The analysis also summarizes typical payer considerations, common modifiers associated with the service line, and where to find related policy or coding guidance.

This publication provides operationally focused information: device description, service classification, payer coverage landscape, and practical coding context. Data not available in the input will be identified as such rather than inferred.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareK0885HCPCS Level IIpower wheelchairdurable medical equipmentmobility devicegroup 4captains chairhome caremedical billing

Billing Code Overview

HCPCS Level II code K0885 describes a power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds. This item is durable medical equipment intended to provide powered mobility for patients with mobility impairments.

Service type: Durable medical equipment — power mobility device
Typical site of service: Home or community settings where an individual uses a power wheelchair for activities of daily living and mobility outside institutional care

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 68-year-old patient with progressive mobility impairment due to advanced Parkinson disease and chronic lower extremity weakness is evaluated by a durable medical equipment (DME) supplier after multiple failed attempts at safe ambulation with a cane and standard walker. The patient has intact cognition to operate a powered mobility device but requires a higher-capacity, heavy-duty power wheelchair to safely transfer and ambulate in the community. The DME clinical workflow includes a clinical needs assessment by a physical therapist, documentation of functional limitations (distance, endurance, transfers), an assessment of home and community barriers, a physician face-to-face or electronic order documenting medical necessity, selection of a K0885 Group 4 standard power wheelchair with captain’s chair and multiple power options to support up to 300 pounds, delivery and seating assessment by a certified ATP (Assistive Technology Professional), patient training on controls, and routine follow-up for warranty and maintenance coordination.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when documentation supports substantially greater preparation, assessment, or modifications for complex seating or customization beyond standard fittings.

HCPCS K0743: Portable Home Suction Pump for Wound Care

HCPCS-K0012-LIGHTWEIGHT-PORTABLE-POWER-WHEELCHAIR

HCPCS K0012: Lightweight Portable Motorized/Power Wheelchair

HCPCS-K0001-STANDARD-WHEELCHAIR-DURABLE-MEDICAL-EQUIPMENT

HCPCS Level II K0001: Standard Wheelchair

HCPCS-K0851-POWER-WHEELCHAIR-HEAVY-DUTY-CAPTAINS-CHAIR-301-450-LBS

HCPCS K0851: Power Wheelchair, Heavy-Duty Captain's Chair (301–450 lb)

HCPCS-K0829-POWER-WHEELCHAIR-EXTRA-HEAVY-DUTY-601-PLUS

HCPCS K0829: Power Wheelchair, Extra Heavy Duty, Captains Chair, 601+ lbs

HCPCS-K0801-POWER-OPERATED-VEHICLE-HEAVY-DUTY-301-450-LBS

HCPCS Level II K0801: Power Operated Vehicle, Heavy Duty 301–450 lbs

HCPCS-K0808-POWER-OPERATED-VEHICLE-VERY-HEAVY-DUTY-451-600-LB

HCPCS K0808: Power Operated Vehicle, Very Heavy Duty (451–600 lb)

HCPCS-K0044-FOOTREST-UPPER-HANGER-BRACKET-REPLACEMENT

HCPCS K0044: Footrest Upper Hanger Bracket Replacement, Each

HCPCS-K0552-SYRINGE-CARTRIDGE-EXTERNAL-DRUG-INFUSION-PUMP

HCPCS K0552: Syringe-Type Cartridge for External Non-Insulin Infusion Pump

HCPCS-K0862-POWER-WHEELCHAIR-GROUP-3-HEAVY-DUTY-301-450-LB-CAPACITY

HCPCS K0862: Power Wheelchair, Group 3 Heavy Duty, 301–450 lb Capacity

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Taxonomy Code	Specialty	Notes
`2080P0800X`	Physical Therapist	Performs mobility and seating assessment, documents functional limitations and training.
`253E00000X`	Assistive Technology Professional (ATP)	Performs device selection, customization, and seating/positioning adjustments.
`207R00000X`	Occupational Therapist	Evaluates activities of daily living, recommends seating and control interfaces.
`207L00000X`	Physical Medicine & Rehabilitation Physician	Provides the physician order, documents medical necessity, and oversees mobility management.
`362Z00000X`	Durable Medical Equipment Supplier	Supplies the `K0885` power wheelchair, manages billing, delivery, and repairs.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G20`	Parkinson disease	Progressive motor impairment and gait dysfunction often necessitate powered mobility for community ambulation.
`G82.50`	Quadriplegia, unspecified	Severe motor impairment that commonly requires a heavy-duty power wheelchair for mobility and positioning.
`G81.90`	Hemiplegia, unspecified affecting unspecified side	Significant unilateral weakness that may prevent safe ambulation and require powered wheelchair use.
`M62.81`	Muscle weakness (generalized)	Global or regional weakness impacting mobility and endurance, supporting need for power mobility.
`R26.2`	Difficulty in walking, not elsewhere classified	Functional gait impairment prompting assessment for power wheelchair.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97530`	Therapeutic activities, direct (one-on-one) patient contact by the provider, involving dynamic activities to improve functional performance	Used by occupational or physical therapists to evaluate and train the patient in transfer and mobility skills prior to wheelchair delivery.
`97161`	Physical therapy evaluation, low complexity	Used for initial PT evaluation documenting deficits and need for powered mobility in lower-complexity cases.
`97162`	Physical therapy evaluation, moderate complexity	Used for PT evaluations with moderate complexity supporting power wheelchair prescription.
`97542`	Wheelchair management (e.g., assessment, fitting, training)	Directly applicable for training and management services associated with power wheelchair provision.
`99456`	Work-related or medical disability examination	Used when functional capacity or work-related mobility assessments are required to support medical necessity determinations.

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