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Official Description

Walker, heavy duty, wheeled, rigid or folding, any type
Short Descr Heavy duty wheeled walker
Coverage Carrier Priced
Pricing Indicator(s) 36 – Supplies And Surgical Dressings - Capped rental DME (price subject to floors and ceilings)
MPI A – Not applicable, as HCPCS priced under one methodology
BETOS D1E – Other DME
TOS Code(s) A – Used durable medical equipment (DME)
Added Date 1/1/2001
APC Status Indicator Non-Implantable Durable Medical Equipment
MUE 0
MUE 1
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
RR Rental (use the 'rr' modifier when dme is to be rented)
KJ Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen
KI Dmepos item, second or third month rental
KH Dmepos item, initial claim, purchase or first month rental
KX Requirements specified in the medical policy have been met
NU New equipment
GZ Item or service expected to be denied as not reasonable and necessary
GA Waiver of liability statement issued as required by payer policy, individual case
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
BP The beneficiary has been informed of the purchase and rental options and has elected to purchase the item
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
GK Reasonable and necessary item/service associated with a ga or gz modifier
GL Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)
K0 Lower extremity prosthesis functional level 0 - does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance their quality of life or mobility.
Date
Action
Notes
2001-01-01 Added Code added 1/1/2001
Code
Description
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