For Providers: Home Medix Insurance Catalog (View Only)

	A	B	C	D
1	HOME MEDIX INSURANCE CATALOG
2	Report any and all errors, as well as any improvements you'd like to see added to the document to docs@homemedix.com
3	NPI:	1851399844	LON = Length of Need
4	HCPCS	Units/Qty for INITIAL Auth	Item

5			Wheelchairs
6	K0001	1	Standard (K1, 16" / 18" / 20"), up to 250lbs
7	K0003	1	Lightweight (K3, 16" / 18"), up to 250lbs
8	K0003	1	Lightweight (K3, 20"), up to 250lbs
9	K0007	1	Extra Heavy Duty (K7, 22", 24", 28", 30") 300-500lbs
10	Check Note*	1	Reclining Wheelchair (16", 18", 20")
11			Wheelchair Accessories
12	K0195	1	Elevated Leg Rests (ELR)
13	E0978	1	Seat Belt for Wheelchair (6")
14	E2209	1	Arm Trough for Wheelchair
15	E2603	1	Gel Cushion (20")
16	E2603	1	Gel Cushion (22")
17	E2603	1	Gel Cushion (24")
18	E2601	1	Foam Cushion (16" / 18" / 20")
19	E2602	1	Foam Cushion (22" / 24" / 28" / 30")
20	E0971	1	Anti-Tippers
21	E0705	1	Transfer Board
22			Transport Chairs
23	E1038	1	Transport Chair (19"), up to 250lbs
24	E1039	1	Bariatric Transport Chair (22" wide), up to 500lbs
25			Power Chairs
26	?	1	Standard	Battery Code:
27	K0823	1	Group 2 (Minimal Surface Irregularity), up to 300lbs. & 3mph	E2365 x2
28	K0825	1	Group 2 (Minimal Surface Irregularity), 301-450lbs. & 3mph	E2361 x2
29	E0827	1	Group 2 (Minimal Surface Irregularity), 451-600lbs. & 3mph
30			Power Scooters
31	K0800	1	Group 1
32	K0806	1	Group 2 (Minimal Surface Irregularity), up to 300lbs. & 3mph
33	K0807	1	Group 2 (Minimal Surface Irregularity), 301-450lbs. & 3mph
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