Wheelchair repair: Fill out & sign online

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to edit Wheelchair Repair Form. DME in PDF format online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Working on paperwork with our comprehensive and intuitive PDF editor is easy. Adhere to the instructions below to complete Wheelchair Repair Form. DME online quickly and easily:

Sign in to your account. Log in with your credentials or create a free account to try the product prior to choosing the subscription.
Upload a form. Drag and drop the file from your device or add it from other services, like Google Drive, OneDrive, Dropbox, or an external link.
Edit Wheelchair Repair Form. DME. Easily add and highlight text, insert images, checkmarks, and icons, drop new fillable areas, and rearrange or delete pages from your paperwork.
Get the Wheelchair Repair Form. DME accomplished. Download your updated document, export it to the cloud, print it from the editor, or share it with other people via a Shareable link or as an email attachment.

Benefit from DocHub, the most straightforward editor to promptly handle your documentation online!

See more Wheelchair Repair Form. DME versions

We've got more versions of the Wheelchair Repair Form. DME form. Select the right Wheelchair Repair Form. DME version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (21 Votes)
2019	4.4 Satisfied (113 Votes)
2015	4 Satisfied (32 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Contact us

What is the CPT code for DME repair?

HCPCS Code for Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes K0739.

What is the HCPCS code for wheelchair repair?

Billing HCPCS Code K0108 - Wheelchair Component or Accessory, Not Otherwise Specified.

What is DME as specified in CCR Title 22 Section 51321 G?

Note: Per Title 22, California Code of Regulations (CCR), Section 51321(g): Authorization for durable medical equipment shall be limited to the lowest cost item that meets a patients medical needs.

What is the KF modifier used for?

KF Modifier Use - Correct Coding HCPCS CodeDescriptorE0764FUNCTIONAL NEUROMUSCULAR STIMULATION, TRANSCUTANEOUS STIMULATION OF SEQUENTIAL MUSCLE GROUPS OF AMBULATION WITH COMPUTER CONTROL, USED FOR WALKING BY SPINAL CORD INJURED, ENTIRE SYSTEM, AFTER COMPLETION OF TRAINING PROGRAM Aug 29, 2019

What is the DME code for manual wheelchair?

Claims for HCPCS codes K0008 (custom manual wheelchair/base) and K0013 (custom motorized, power wheelchair base) must be billed with modifiers NU or RB. HCPCS codes E2312, E2321, E2322, E2327 and E2373 are special power wheelchair interface procedure codes.

Related forms

be ready to get more