K0859 prior authorization | Premera Blue Cross of Washington

K0859, Power wheelchair, group 3 heavy-duty, single power option, captain's chair, patient weight capacity 301 to 450 pounds These criteria do not imply or guarantee approval., is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: K0859
Description: Power wheelchair, group 3 heavy-duty, single power option, captain's chair, patient weight capacity 301 to 450 pounds These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 751 Original policy

Premera Blue Cross of Washington prior authorization

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