K0862 prior authorization | Premera Blue Cross of Washington
K0862, Power wheelchair, group 3 heavy-duty, multiple power option, sling/solid seat/back, 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
- K0862
- Description
- Power wheelchair, group 3 heavy-duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds These criteria do not imply or guarantee approval.
- Source
- Clinical Review by Code List PBCWA, Pg 752 Original policy