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HCPCS Modifier K4

Official Description

Lower extremity prosthesis functional level 4 - has the ability or potential for prosthetic ambulation that exceeds the basic ambulation skills, exhibiting high impact, stress, or energy levels, typical of the prosthetic demands of the child, active adult, or athlete.

Short Descr	Lwr ext prost functnl lvl 4
Medium Descr	Lwr ext prost functnl lvl 4
Coverage	Carrier Priced
Added Date	1/1/1993

Modifiers

K0-KZ K Modifiers

K0 Lwr ext prost functnl lvl 0

K1 Lwr ext prost functnl lvl 1

K2 Lwr ext prost functnl lvl 2

K3 Lwr ext prost functnl lvl 3

K4 Lwr ext prost functnl lvl 4

KA Wheelchair add-on option/acc

KB >4 modifiers on claim

KC Repl special pwr wc intrface

KD Drug/biological dme infused

KE Bid under round 1 dmepos cb

KF Fda class iii device

KG Dmepos comp bid prgm no 1

KH Dmepos ini clm, pur/1 mo rnt

KI Dmepos 2nd or 3rd mo rental

KJ Dmepos pen pmp or 4-15mo rnt

KK Dmepos comp bid prgm no 2

KL Dmepos mailorder comp bid

KM Rplc facial prosth new imp

KN Rplc facial prosth old mod

KO Single drug unit dose form

KP First drug of multi drug u d

KQ 2nd/subsqnt drg multi drg ud

KR Rental item partial month

KS Glucose monitor supply

KT Item from noncontract supply

KU Dmepos comp bid prgm no 3

KV Dmepos item, profession serv

KW Dmepos comp bid prgm no 4

KX Documentation on file

KY Dmepos comp bid prgm no 5

KZ New cov not implement by m+c

Date	Action	Notes
1993-01-01	Added	Code added 1/1/1993

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