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K0669

K0669Wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from dme pdac

HCPCSActiveBETOS D1D

K0669 is a HCPCS Level II code for wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from dme pdac. It belongs to the Durable Medical Equipment (DME MAC Temporary) section. Whether Medicare pays it depends on the coverage rule below.

Medicare coverage: Carrier judgment

Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.

From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.

Medically Unlikely Edits — units per day

The most units of K0669 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.

practitioner
0 — never payable
MAI 3 — Date of Service Edit: Clinical · CMS Policy
outpatient
0 — never payable
MAI 3 — Date of Service Edit: Clinical · CMS Policy
DME supplier
0 — never payable
MAI 3 — Date of Service Edit: Clinical · Published Contractor Policy

The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.

The CMS record for K0669

Long descriptor
Wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from dme pdac

The official wording. This is what the code means.

Short descriptor
Seat/back cus no dmepdac ver

CMS's 28-character form, which is what shows up on a remittance advice.

Added
July 1, 2004

When CMS introduced the code.

BETOS
D1D

Berenson-Eggers Type of Service — CMS's own analytic grouping.

Pricing indicator
32 — DMEPOS

Inexpensive and routinely purchased DME. Price subject to floors and ceilings.

Codes adjacent to K0669

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If K0669 is not quite right, the correct code is very often within a few positions of it.

  • K0602Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each
  • K0603Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each
  • K0604Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each
  • K0605Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each
  • K0606Automatic external defibrillator, with integrated electrocardiogram analysis, garment type
  • K0607Replacement battery for automated external defibrillator, garment type only, each
  • K0608Replacement garment for use with automated external defibrillator, each
  • K0609Replacement electrodes for use with automated external defibrillator, garment type only, each
  • K0672Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each
  • K0730Controlled dose inhalation drug delivery system
  • K0733Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)
  • K0738Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing
  • K0739Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes
  • K0740Repair or nonroutine service for oxygen equipment requiring the skill of a technician, labor component, per 15 minutes
  • K0743Suction pump, home model, portable, for use on wounds
  • K0744Absorptive wound dressing for use with suction pump, home model, portable, pad size 16 square inches or less

Questions about K0669

What is HCPCS code K0669?

K0669 is a HCPCS Level II code for wheelchair accessory, wheelchair seat or back cushion, does not meet specific code criteria or no written coding verification from dme pdac. It sits in the Durable Medical Equipment (DME MAC Temporary) section.

Does Medicare cover K0669?

The CMS HCPCS file marks K0669 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.

HCPCS Level II2026Q3-Jul· effective July 1, 2026