HCPCS 'K' Modifiers (31)

Modifier Description
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.
K1 Lower extremity prosthesis functional level 1 - has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. typical of the limited and unlimited household ambulator.
K2 Lower extremity prosthesis functional level 2 - has the ability or potential for ambulation with the ability to traverse low level environmental barriers such as curbs, stairs or uneven surfaces. typical of the limited community ambulator.
K3 Lower extremity prosthesis functional level 3 - has the ability or potential for ambulation with variable cadence. typical of the community ambulator who has the ability to transverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion.
K4 Lower extremity prosthesis functional level 4 - has the ability or potential for prosthetic ambulation that exceeds the basic ambulation skills, exhibiting high impact, stress, or energy levels, typical of the prosthetic demands of the child, active adult, or athlete.
KA Add on option/accessory for wheelchair
KB Beneficiary requested upgrade for abn, more than 4 modifiers identified on claim
KC Replacement of special power wheelchair interface
KD Drug or biological infused through dme
KE Bid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipment
KF Item designated by fda as class iii device
KG Dmepos item subject to dmepos competitive bidding program number 1
KH Dmepos item, initial claim, purchase or first month rental
KI Dmepos item, second or third month rental
KJ Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen
KK Dmepos item subject to dmepos competitive bidding program number 2
KL Dmepos item delivered via mail
KM Replacement of facial prosthesis including new impression/moulage
KN Replacement of facial prosthesis using previous master model
KO Single drug unit dose formulation
KP First drug of a multiple drug unit dose formulation
KQ Second or subsequent drug of a multiple drug unit dose formulation
KR Rental item, billing for partial month
KS Glucose monitor supply for diabetic beneficiary not treated with insulin
KT Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item
KU Dmepos item subject to dmepos competitive bidding program number 3
KV Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service
KW Dmepos item subject to dmepos competitive bidding program number 4
KX Requirements specified in the medical policy have been met
KY Dmepos item subject to dmepos competitive bidding program number 5
KZ New coverage not implemented by managed care