CGS and Noridian DME MACs' LCD L33792 (Wheelchair Options/Accessories) adds coverage criteria for a power seat elevation system (K0108) added onto non-complex Group 2 no-power or Group 5 power wheelchairs, requiring the beneficiary to rely on the PWC as primary in-home mobility, meet upper-extremity transfer or MRADL criteria, need at least 50% mobility assistance per a standardized scale, and have a specialty evaluation by an LCMP. It also clarifies the pressure-ulcer example language for power tilt/recline systems and sets E2298 criteria separately. The source states an effective date of 12/20/2026, which is after the 2026-11-06 analysis date, so this is a future change.
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01Before 2026-12-20: Billing team should review the new K0108 seat elevation criteria (A-D) and E2298 clarifications, and confirm with DME ordering providers and front desk staff that PT/OT or LCMP specialty evaluations documenting medical necessity, the 50% mobility-assistance rating, and PWC-as-primary-mobility status are obtained and filed before K0108 orders are taken and delivered.
02Update charge entry and pre-billing checklists so K0108 claims include the supporting documentation and the Standard Written Order and proof of delivery requirements in the LCD.
03Watch for the response-to-comments article (A60577) and any updated Power Mobility Devices LCD references.
04Per the LCD, claims for K0108 that do not meet these criteria will be denied as not reasonable and necessary, so verify documentation before delivery rather than after billing.
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