HCPCS Code K0005: Ultralightweight Manual Wheelchair Base

Use KX only when all coverage criteria in the LCD are fully met and documented, including the specialty evaluation, the in-home requirement, and a clear justification that K0005’s individualized configuration is required versus a high-strength lightweight wheelchair such as K0004.

ADMC allows a voluntary pre-delivery review of medical necessity for eligible manual wheelchair bases, including K0005 in certain jurisdictions. A favorable decision reduces the risk of post-delivery denials when documentation clearly shows medical necessity, although it is not a guarantee of payment. Verify eligibility with your DME MAC.

RT/LT does not apply to the K0005 base. However, if you choose to append RT and LT to bilateral wheelchair options and accessories with a unit of service of “each,” you must bill them on two separate lines with one unit each. Using “RTLT” on a single line in that case constitutes incorrect coding.