Summary & Overview
HCPCS Level II K0807: Power Operated Vehicle, Group 2 Heavy Duty
HCPCS Level II code K0807 denotes a power-operated vehicle, group 2 heavy duty, designed to support patients with weights from 301 to 450 pounds. Nationally, this code matters because it identifies high-capacity power mobility devices that address increasing clinical needs for bariatric and higher-weight patients who require durable mobility solutions. Coverage and payment policies for such equipment affect patient access, supplier billing practices, and durable medical equipment (DME) program expenditures.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical purpose and typical sites of use, followed by benchmarking and policy context where available. The publication summarizes common modifiers and administrative considerations, highlights how payers typically classify and process claims for heavy-duty power-operated vehicles, and outlines typical documentation elements used to support medical necessity.
This summary is intended for clinicians, billing professionals, DME suppliers, and policy analysts seeking to understand what K0807 represents, which payers commonly cover it, and what types of benchmarks and policy updates to expect when managing claims for heavy-duty power mobility devices. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code K0807 describes a power operated vehicle, group 2 heavy duty, with a patient weight capacity of 301 to 450 pounds. This item is a durable medical equipment product intended to provide mobility assistance for patients who require a power-operated wheelchair with an elevated weight capacity.
Service type: Durable Medical Equipment (power mobility device)
Typical site of service: Home or community use, including ambulatory and residential settings where long-term mobility support is required.
Clinical & Coding Specifications
Clinical Context
A typical patient is a middle-aged or older adult with mobility limitations and a body weight between 301 and 450 pounds who requires a power-operated wheelchair rated for group 2 heavy duty use. The patient often presents to a multidisciplinary durable medical equipment (DME) clinic after evaluation by a primary care physician, physiatrist, or rehabilitation specialist for difficulty ambulating safely in the community due to neuromuscular weakness, severe osteoarthritis, morbid obesity with mobility impairment, spinal cord injury sequelae, or advanced cardiopulmonary disease. A standardized workflow includes initial clinical assessment (history, functional mobility exam, home environment review), documentation of weight and need for a higher-capacity base, trial of mobility aids as appropriate, DME supplier measurement and product selection, medical necessity documentation (demonstrating inability to ambulate or safely use a standard wheelchair), completion of supplier order form with billing code K0807, and coordination with the payor for prior authorization when required. Follow-up includes delivery, patient training, and periodic reassessment for repairs, adjustments, or replacement.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
KX | Requirements specified in the medical policy are met | Use when documentation meets payer medical necessity rules for power-operated vehicle coverage |