K0831 — Power wheelchair, group 2 standard, seat elevator, captains chair, patient weight capacity up to and including 300 pounds

HCPCS Level II K-code · short descriptor: “Pwc gp2 std seat elevate cap”

Code system: HCPCS Level II
Family: K — DME MAC temporary codes
Medicare coverage status: Carrier judgment — coverage decided by the DME MAC
Prior authorization: Not on Medicare required-PA list
Face-to-face & WOPD: Required from 2026-10-28 (Power Mobility Devices)
MUE unit limit: 1
Status: Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-26; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
General description of the item (42 CFR 410.38(d)(1)(i)(B))
Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
Order date (42 CFR 410.38(d)(1)(i)(D))
Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

F2F + WOPD FROM 2026-10-28 K0831 joins Medicare's Required Face-to-Face & WOPD List for dates of service on or after 2026-10-28 (Power Mobility Devices — CMS-6109-N, 91 FR 47972 (published 2026-07-30)). From that date two extra conditions of payment apply:

Face-to-face encounter (in-person or telehealth) with the treating practitioner within the 6 months before the order date
Written order communicated to the supplier before delivery (WOPD)

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps K0831 at 1 unit per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Code Descriptor / CPT Instruction.

Common denial codes to watch

CO-50 medical necessity CO-151 frequency/units

Bill K0831 with confidence

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