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Prior Authorization: Which Codes Attach to Base Only vs. All Accessories

When you’re preparing a PA request for power wheelchairs, here’s how it breaks down:

PA Attaches to Base AND All Accessories

These codes mean the prior authorization, once affirmed, applies to the base and all accessories submitted—no matter if they’re on the voluntary list or not:

  • K0005 – Ultralightweight wheelchair
  • E1161 – Manual wheelchair with one-arm drive mechanism (base rental)
  • K0823 – Power wheelchair, Group 2 very heavy duty (base rental)

PA Attaches to Base + Voluntary Accessories Only

For these codes, the PA only covers the base and accessories submitted that are on the voluntary prior authorization list. Accessories not on the voluntary list go through standard claims review, even if you submit them on your PAR:

  • K0861 – Group 3 standard, multiple power options
  • K0841 – Group 3 heavy duty, multiple power options
  • K0843 – Group 3 very heavy duty, multiple power options

PA Attaches to Base ONLY

For these codes, PA is strictly for the base—no accessories are included, so submit accessories through normal claims:

  • K0821 – Group 2 standard
  • K0825 – Group 2 heavy duty

Voluntary Prior Authorization Accessory List

The following accessory codes are eligible for voluntary prior authorization when submitted with applicable base codes:

Power Seating Systems

  • E0950 – Wheelchair accessory, tray
  • E0955 – Wheelchair accessory, headrest extension
  • E1002 – Wheelchair accessory, power seating system, tilt only
  • E1003 – Wheelchair accessory, power seating system, recline only
  • E1004 – Wheelchair accessory, power seating system, recline only, mechanical shear reduction
  • E1005 – Wheelchair accessory, power seating system, recline only, power shear reduction
  • E1006 – Wheelchair accessory, power seating system, combination tilt and recline
  • E1007 – Wheelchair accessory, power seating system, combination tilt and recline, mechanical shear reduction
  • E1008 – Wheelchair accessory, power seating system, combination tilt and recline, power shear reduction
  • E1009 – Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system
  • E1010 – Wheelchair accessory, addition to power seating system, power leg elevation system
  • E1012 – Wheelchair accessory, addition to power seating system, center mount power elevating leg rest

Ventilator and Positioning Accessories

  • E1029 – Wheelchair accessory, ventilator tray
  • E1030 – Wheelchair accessory, ventilator tray, gimbaled

Power Wheelchair Components

  • E2310 – Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor
  • E2311 – Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors
  • E2312 – Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick
  • E2313 – Power wheelchair accessory, harness for upgrade to expandable controller

Power Wheelchair Control Systems

  • E2321 – Power wheelchair accessory, hand control interface, remote joystick, nonproportional
  • E2322 – Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional
  • E2323 – Power wheelchair accessory, specialty joystick handle for hand control interface
  • E2324 – Power wheelchair accessory, chin cup for chin control interface
  • E2325 – Power wheelchair accessory, sip and puff interface, nonproportional
  • E2326 – Power wheelchair accessory, breath tube kit for sip and puff interface
  • E2327 – Power wheelchair accessory, head control interface, mechanical, proportional
  • E2328 – Power wheelchair accessory, head control or extremity control interface, electronic, proportional
  • E2329 – Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional
  • E2330 – Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional

Electronic Interfaces and Controls

  • E2351 – Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface
  • E2373 – Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional
  • E2377 – Power wheelchair accessory, expandable controller, including all electronics, switches or interface

Seating and Positioning Components

  • E2601 – General use wheelchair seat cushion, width less than 22 inches, any depth
  • E2602 – General use wheelchair seat cushion, width 22 inches or greater, any depth
  • E2603 – Skin protection wheelchair seat cushion, width less than 22 inches, any depth
  • E2604 – Skin protection wheelchair seat cushion, width 22 inches or greater, any depth
  • E2605 – Positioning wheelchair seat cushion, width less than 22 inches, any depth
  • E2606 – Positioning wheelchair seat cushion, width 22 inches or greater, any depth
  • E2607 – Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth
  • E2608 – Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth

Back Cushions

  • E2611 – General use wheelchair back cushion, width less than 22 inches, any height
  • E2612 – General use wheelchair back cushion, width 22 inches or greater, any height
  • E2613 – Positioning wheelchair back cushion, posterior, width less than 22 inches, any height
  • E2614 – Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height
  • E2615 – Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height
  • E2616 – Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height

Additional Positioning Accessories

  • E2620 – Positioning wheelchair back cushion, planar back with lateral supports
  • E2621 – Positioning wheelchair back cushion, planar back without lateral supports
  • E2622 – Skin protection and positioning wheelchair seat cushion, adjustable
  • E2623 – Skin protection and positioning wheelchair back cushion, adjustable
  • E2624 – Positioning wheelchair back cushion, contoured back
  • E2625 – Positioning wheelchair back cushion, anterior or anterior/lateral

Other Accessories

  • K0020 – Standard wheelchair cushion
  • K0195 – Elevating leg rests, pair

Quick Reference

If submitting accessories with a base:

  • For K0005, E1161, or K0823: The PA covers the base and all accessories on the request.
  • For K0861, K0841, or K0843: The PA covers the base and only accessories on the voluntary PA list above.
  • For K0821 or K0825: PA applies to the base only, regardless of what accessories you submit.

Important Reminder

Once a base PA is affirmed, you cannot go back and request voluntary PA for accessories later. Include all desired voluntary accessories on the initial base PA request.

priorauth powerchairs accessories