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HOME MEDIX INSURANCE CATALOG
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Report any and all errors, as well as any improvements you'd like to see added to the document to docs@homemedix.com
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NPI:1851399844
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HCPCS
Units/Qty for Initial Auth
Item
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Wheelchairs
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K000113Standard (K1, 16" / 18" / 20"), up to 250lbs
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K000313Lightweight (K3, 16" / 18"), up to 250lbs
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K000313Lightweight (K3, 20"), up to 250lbs
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K000713Extra Heavy Duty (K7, 22", 24", 28", 30") 300-500lbs
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Check Note*13Reclining Wheelchair (16", 18", 20")
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Wheelchair Accessories
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K019513Elevated Leg Rests (ELR)
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E0978Item Quantity on OrderSeat Belt for Wheelchair (6")
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E2209Item Quantity on OrderArm Trough for Wheelchair
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E2603Item Quantity on OrderGel Cushion (20")
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E2603Item Quantity on OrderGel Cushion (22")
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E2603Item Quantity on OrderGel Cushion (24")
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E2601Item Quantity on OrderFoam Cushion (16" / 18" / 20")
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E2602Item Quantity on OrderFoam Cushion (22" / 24" / 28" / 30")
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E097113Anti-Tippers
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E0705Item Quantity on OrderTransfer Board
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Transport Chairs
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E103813Transport Chair (19"), up to 250lbs
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E103913Bariatric Transport Chair (22" wide), up to 500lbs
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Power Chairs
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?Item Quantity on OrderStandardBattery Code:
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K0823Item Quantity on OrderGroup 2 (Minimal Surface Irregularity), up to 300lbs. & 3mphE2365 x2
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K0825Item Quantity on OrderGroup 2 (Minimal Surface Irregularity), 301-450lbs. & 3mphE2361 x2
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E0827Item Quantity on OrderGroup 2 (Minimal Surface Irregularity), 451-600lbs. & 3mph
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Power Scooters
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K0800Item Quantity on OrderGroup 1
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K0806Item Quantity on OrderGroup 2 (Minimal Surface Irregularity), up to 300lbs. & 3mph
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K0807Item Quantity on OrderGroup 2 (Minimal Surface Irregularity), 301-450lbs. & 3mph
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