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Independence Blue CrossCommercial · Prior Auth · Medical Policy · PA · Physical Therapy, Occupational Therapy, PM&R (Physical Medicine & Rehab) +2 moreHigh impact

05.00.67w, Wheelchair Options and Accessories

Effective date
Oct 28, 2026
Identified
Nov 3, 2026

Summary

Independence Blue Cross added face-to-face encounter and written order prior authorization requirements to eight wheelchair HCPCS codes (E1161, K0002, K0003, K0004, K0005, K0006, K0007, K0831) effective 10/28/2026, aligning with Medicare Final Rule. The practice must obtain prior authorization before these wheelchairs are delivered or prior to authorization issuance.

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What to do

Action · 5 steps
01Effective 10/28/2026: Obtain prior authorization for HCPCS codes E1161, K0002, K0003, K0004, K0005, K0006, K0007, and K0831 before scheduling wheelchair delivery or authorizing the device.
02Update charge entry and prior auth workflows to require documentation of a face-to-face encounter and written order in the patient's medical record prior to submitting these claims.
03Instruct front desk staff to coordinate with providers to ensure the face-to-face encounter and written order are completed before the wheelchair is delivered.
04Notify suppliers and durable medical equipment (DME) vendors that prior authorization must be obtained in advance.
05Claims submitted without prior authorization for these codes will be denied.

Codes mentioned

E1161K0002K0003K0004K0005K0006K0007K0831

Original notice

05.00.67w, Wheelchair Options and Accessories
medpolicy.ibx.com · Always check the source before changing claims.
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Related changes

See all Independence Blue Cross changes →
MA05.046l, Wheelchair Options and AccessoriesHighEffective Oct 28, 2026 · Medical PolicyMA05.026f, Manual WheelchairsHighEffective Oct 28, 2026 · Medical Policy05.00.12l, Manual WheelchairsMediumEffective Oct 28, 2026 · Medical PolicyMA05.026d, Manual WheelchairsMediumNo effective date · Medical PolicyBrowse every Independence Blue Cross change in the policy list

Related policy hubs

Independence Blue Cross policiesPA policy changesPhysical TherapyOccupational TherapyPM&R (Physical Medicine & Rehab)GeriatricsGeneral PracticeCode E1161Code K0002Code K0003Code K0004Code K0005Code K0006Code K0007Code K0831

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