SADMERC Letters for Funding

SADMERC Letters for Funding Healthcare Common Procedure Coding System (HCPCS Codes), are numbers assigned to every task, service, and product a medical practitioner may provide to a Medicare / Medicaid patient. Wheelchair products are classified based on similarities in function and if the products exhibit significant therapeutic differences from other products. Since everyone uses the same HCPCS funding codes, it ensures uniformity throughout the medical community. For a detailed overview, please refer to http://www.cms.hhs.gov/MedHCPCSGenInfo/

HCPCS Code Letters

“Code letters” are the letters Karman received that state the code given to certain Karman products. These can be downloaded and sent to your insurance companies, etc to provide the codes for the chair. HCPCS – K0005 – S-ERGO 300 Series – Ultralightweight Wheelchair HCPCS – K0005 / E1236 – ERGO ATX – Ultralightweight Wheelchair HCPCS – K0004 – S-ERGO 100 Series – High Strength Ultralight Wheelchair HCPCS – K0004 / K0005 – LT-K5 – High Strength Lightweight Wheelchair HCPCS – K0003 / E2201 – MVP-502 Series – Lightweight Reclining Wheelchair HCPCS – K0004 – LT-980 Series – High Strength Lightweight Wheelchair HCPCS – E0245 / E0240 – Shower Chairs HCPCS – E0143 – R-4602 Rollator HCPCS – E0274 – Overbed Table HCPCS – E0138 – KW-100 Knee Walker HCPCS – K0007 / E2201 – KM-8520 – Extra Heavy Duty Wheelchair HCPCS – E0163 – Commode HCPCS – K0004 / K0005 – KM-802 Series – High Strength Ultralight Wheelchair HCPCS – K0007 / K0028 – KM-5000 Series – High Strength Light Reclining Wheelchair HCPCS – K0004 – KM-8020 Series – High Strength Ultralight Wheelchair HCPCS – K0004 – KM-9020 Series – High Strength Ultralight Wheelchair HCPCS – E1038 – TV-10B – Transport Travel Wheelchair HCPCS – K0001 – KN-700 Series – Standard Weight Wheelchair HCPCS – K0003 – LT-700 Series – Standard Lightweight Wheelchair HCPCS – K0003 – LT-800 Series – Standard Lightweight Wheelchair HCPCS – K0003 – KN-800 Series – Standard Lightweight Wheelchair HCPCS – K0003 – KN-880 Series – Standard Lightweight Wheelchair HCPCS – K0007 – KN-900 Series – Extra Heavy Duty Wheelchair HCPCS – E0138 – LT-2000 Series – Transport Wheelchair HCPCS – E0143 – R-3000 Series Rollator HCPCS – E0143 / E0156 – R-4000 Series Rollator HCPCS – E0143 / E0156 – R-5000 Series Rollator HCPCS – E0138 – T-2000 STD Series – Transport Wheelchair HCPCS – E0138 – T-1000 Series – Transport Wheelchair HCPCS – E1038 – T-2700 STD Series – Transport Wheelchair HCPCS – E1038 – T-3000 Series – Transport Wheelchair HCPCS – E0135 – Folding Walker Aluminum Series HCPCS – E1038 – LT-1000 Series – Transport Wheelchair Up to 300 lbs

The above HCPCS Codes for Karman Wheelchairs can be used with below Manual Wheelchair Accessories

Transit Accessories	HCPCS	HCPCS Code Description
2-Point Belt	E0978	Wheelchair accessory, positioning belt/safety belt/pelvic strap, each
3-Point Belt	E0978	Wheelchair accessory, positioning belt/safety belt/pelvic strap, each
Adjustable Contour Headrest	E0955	Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each
Anterior Trunk Support	E0960	Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware
Frame Options	HCPCS	HCPCS Code Description
Recline	E1225	Wheelchair accessory, manual semi-reclining back(recline greater than 15 degrees, but less than 80 degrees), each
Tilt	E1161	Adult Tilt in Space
Pelvis Positioning Options	HCPCS	HCPCS Code Description
2-Point Belt	E0978	Wheelchair accessory, positioning belt/safety belt/pelvic strap, each
3-Point Belt	E0978	Wheelchair accessory, positioning belt/safety belt/pelvic strap, each
Support Cushion – General Use Flat Solid Seat	E2601	General use  wheelchair seat cushion, width less than 22 inches, any depth
Position Cushion – Medial Thigh Support/Anti Thrust	E2607	Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth
Align Cushion – Lateral Pelvis/Lateral Thigh Support	E2607	Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth
Foot & Leg Positioning	HCPCS	HCPCS Code Description
Angle Adjustable Footplates	K0040	Adjustable angle footplate, each
Medial Thigh Support (Abductor/Pommel)	E0957	Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware
Lateral Thigh Support (Adductor)	E0956	Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each
Medial Thigh Support (Pommel)	E0957	Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware
S/A Adj. Hardware for Left Lateral Thoracic Support	E0128	Wheelchair accessory, manual swing away, retractable or removable mounting hardware for joystick, other control interface or positioning accessory
Ball Join	E2345	Accessory on pivot point for conjunction
Trunk Positioning	HCPCS	HCPCS Code Description
H-harness with Padded covers	E0960	Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware
Anterior Trunk Support	E0960	Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware
SA Adj. Lateral Support (Single Flap) with Scoli Strap	E0956	Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each
Thoracic Support	E0956	Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each
Swing Away Hardware for Thoracic Support	E1028	Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory
Adj Firm Lateral Thoracic Supports (Contoured)	E0956	Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each
Anterior Trunk Support	E0960	Wheelchair accessory,
Head Support	HCPCS	HCPCS Code Description
Padded Headwings	E0955	Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each
Headrest Extension	E0966	Manual wheelchair accessory, headrest extension, each
Adjustable Contour Headrest	E0955	Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each
Contoured Firm Headrest	E0955	Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each
Firm Backrest Extension – Flat or Contoured	E0966	Manual wheelchair accessory, headrest extension, each
Headrest Extension Folding	n/a	Foldable
Wheel Locks	HCPCS	HCPCS Code Description
Caster Lock	K0073	Caster pin lock each
Caster Lock	K0073	Caster pin lock each
Accessories	HCPCS	HCPCS Code Description
Upper Extremity Support Surface (Tray)	E0950	Wheelchair accessory, tray, each
Crash Tested Foam Tray	E0950	Wheelchair accessory, tray, each
Oxygen Tank Bag	E2208	Wheelchair accessory, cylinder tank carrier, each
Rear Anti-Tip Tubes	E0971	Manual wheelchair accessory, anti-tipping device, each

*The HCPCS codes provided on this form are based on code verification through PDAC or our interpretation of the code definitions. DME providers are responsible for determining appropriate billing codes for their service areas when submitting for insurance reimbursement. HCPCS codes provided on this form should not be considered as legal advice.