HCPCS code K0077 – Front caster assembly with solid tire

Key takeaways

HCPCS code K0077 is a complete front caster assembly with a solid tire, billed per caster and only as a replacement part.

The tire type picks the code. Use K0071 for a pneumatic tire, K0072 for a semi-pneumatic tire, and K0077 for a solid tire.

K0077 is an inexpensive or routinely purchased item, so it takes NU, UE or RR rather than BP, BR or BU. CR and EY apply only in narrow cases.

Power wheelchair caster parts have their own codes. E2395 is the caster wheel, E2396 the caster fork, and E2384 and E2387 to E2392 cover tires.

Pabau, the billing and practice software we build, keeps the order, the delivery record and the claim together. The billed code then matches the part delivered.

HCPCS code K0077: Official descriptor and key details

HCPCS code K0077 describes a front caster assembly, complete, with solid tire, replacement only, each. It is billed when a worn or damaged front caster on a beneficiary-owned wheelchair is replaced with a solid-tire unit. The short descriptor on claim forms is “Fr cstr asmb sol tire rep ea.”

K-codes are temporary HCPCS Level II codes that CMS maintains for durable medical equipment. The annual HCPCS file takes effect on January 1, and CMS publishes quarterly updates during the year. Confirm the code is active for your date of service in the CMS HCPCS overview and annual code files before billing.

What K0077 covers and what it excludes

K0077 covers one complete front caster assembly: the fork, the wheel and a solid tire supplied together. It is billed for a replacement when the original caster is worn, damaged or no longer safe. “Replacement only” means the code is never billed with a new wheelchair, because the base code already includes its casters.

Billed under K0077: A complete solid-tire front caster assembly that replaces the original on a beneficiary-owned wheelchair, one unit per caster.

Not billed under K0077: Front casters with a pneumatic or semi-pneumatic tire, rear wheels, armrests, footrests and anti-tip devices. Separate power wheelchair component parts are not billed here either. A power wheelchair caster wheel is E2395, and a caster fork is E2396. Power wheelchair tires fall under E2384 and E2387 to E2392, and E2384, E2387, E2389, E2391 and E2392 are the caster tires.

K0077 vs K0071 and K0072: Pick the code by tire type

K0077 has two close neighbors, and the tire is the only thing that separates them. All three codes describe a complete front caster assembly, replacement only, billed per caster. Bill the code that matches the tire on the part your delivery record shows.

Do not treat these three codes as strictly manual-wheelchair codes. Some payer tables list K0071, K0072 and K0077 alongside E2395 and E2396 for certain wheelchair bases. Check the payer’s own code table for the base on file before you choose.

E2395 and E2396 are separate component codes, not alternatives for a complete assembly. E2395 is a power wheelchair caster wheel that excludes the tire, and E2396 is a caster fork of any size. Bill them only when that individual part is supplied on its own. No E-code describes a complete power wheelchair front caster assembly. The chart below sorts each replacement caster part to its code.

Two other codes come up in the same claims. K0017 is a detachable, adjustable height armrest base, replacement only, each, and it is unrelated to casters. K0108 is the not-otherwise-specified wheelchair component code, and it should not be used when K0071, K0072 or K0077 describes the part.

Medicare coverage criteria for K0077

Medicare Part B covers K0077 as a DMEPOS item when the replacement is reasonable and necessary and the wheelchair itself is covered. The supplier must be enrolled, accredited and bonded as a DMEPOS supplier. Coverage follows the DME MAC wheelchair options and accessories policy for the beneficiary’s jurisdiction.

Four DME MAC jurisdictions handle these claims, and two contractors run them. Noridian Healthcare Solutions administers Jurisdictions A and D, and CGS Administrators administers Jurisdictions B and C.

Key conditions for K0077 coverage under Medicare:

• The beneficiary has a valid order from a treating physician or other qualified practitioner
• The wheelchair that receives the caster is covered under Medicare’s DME benefit
• The caster replaces a worn or damaged part, and it is not a convenience or cosmetic upgrade
• The supplier is enrolled in PECOS as a DMEPOS supplier
• The claim is filed within the timely filing limit, which is generally one year from the date of service

ICD-10-CM codes that support K0077

A K0077 claim carries the diagnosis that explains why the beneficiary needs a wheelchair. The caster itself has no diagnosis of its own. Pick the most specific code the medical record supports, and list wheelchair dependence where the payer asks for it.

These are common examples, not a payer-approved list. Use the code that the treating practitioner documented, and code to the highest specificity the record allows.

Documentation requirements for K0077 claims

K0077 documentation has to prove two things: why the caster needed replacing, and which caster was delivered. At minimum, the claim file should contain:

• A written order, signed and dated on or before delivery, that names the front caster assembly being replaced
• Records showing the beneficiary uses the wheelchair and why the original caster is worn, damaged or unsafe
• Proof of delivery signed by the beneficiary or an authorized representative
• An invoice or product record showing the tire type, so the billed code matches the part delivered

Auditors flag K0077 claims where the order is unsigned or undated, or where it describes a different part. Sound medical billing compliance checks catch an unsigned order or a mismatched part before the claim goes out.

Modifiers used with K0077

K0077 carries pricing indicator 32, which marks it as inexpensive or routinely purchased DME. That decides the pricing modifier. A missing or wrong modifier is one of the most common reasons a K0077 claim is rejected or adjusted.

BP, BR and BU are not normally required on K0077, because they apply to purchase or rental elections on capped rental items. Confirm each payer’s preference in the DME MAC supplier manual before you submit. The AAPC HCPCS code lookup lists descriptors and related codes.

Prior authorization and competitive bidding for K0077

K0077 is not on the Medicare Required Prior Authorization List for DMEPOS items under traditional Medicare. That list focuses on power mobility devices and other high-cost items. Prior authorization rules still vary by payer, so check each one before supplying the part.

Commercial payers and Medicaid managed care plans may require prior authorization for wheelchair parts, including K0077. Check the payer portal before delivery. A claim submitted without required prior authorization usually comes back with CARC CO-197.

Under the DMEPOS Competitive Bidding Program, check whether K0077 falls in a product category bid for the beneficiary’s area. Where it does, only a contract supplier can furnish it to Medicare beneficiaries there. Fee schedule amounts can also differ between bid and non-bid areas.

K0077 fee schedule and reimbursement

CMS publishes the DMEPOS fee schedule each year, with rates effective January 1 and quarterly updates. Medicare allows the lower of the billed charge or the fee schedule amount for the beneficiary’s state. Verify the current amount in the Medicare Informatics HCPCS fee schedule tables or the CMS DMEPOS fee schedule files before quoting a cost share.

• Medicare pays 80% of the allowed amount after the Part B deductible, and the beneficiary owes the remaining 20%
• Fee schedule amounts are set by state, and some states carry separate rural and non-rural amounts
• Amounts in Competitive Bidding Areas reflect bid prices and are often lower
• Bill one unit per caster, so two replaced front casters are two units

How to bill K0077: Step-by-step claim submission

Accurate K0077 billing follows the same sequence every time. A slip at any step raises the risk of denial or recoupment. Review medical billing fundamentals if any step is unclear.

1. Confirm the written order: Check that the practitioner signed and dated the order on or before delivery. It should name the front caster assembly, not a generic “wheelchair part.”
2. Verify eligibility and coverage: Confirm Part B enrollment, your supplier enrollment and any competitive bidding contract for the beneficiary’s area.
3. Select the code by tire type: Bill K0077 for a solid-tire assembly, K0071 for a pneumatic tire and K0072 for a semi-pneumatic tire. Bill E2395 or E2396 only when that individual power wheelchair part is supplied on its own.
4. Attach the pricing modifier: Use NU for a new caster, UE for a used one or RR for a rental. Add RB only where the payer accepts it for repair parts, and CR or EY only in the cases above.
5. Link a supporting diagnosis code: Attach the ICD-10-CM code for the condition that requires the wheelchair, such as Z99.3 for wheelchair dependence.
6. Complete the CMS-1500 or 837P claim: Enter K0077 in field 24D with one unit per caster. Place of service is usually 12 when the part is fitted at the beneficiary’s home.
7. Submit and retain documentation: Submit electronically through your clearinghouse, and keep the order, repair notes and proof of delivery for at least seven years.

Common K0077 denial reasons and how to fix them

K0077 denials cluster around a few recurring problems. The reason code on the remittance advice points to the fix. Structured denial management workflows help you track and clear these patterns.

For appeals, the CARC denial codes reference matches each reason code to its appeal route. Pabau’s claims management software shows denial reason codes on the claim record, so billing staff act without switching between systems.

When an ABN is required for K0077

An Advance Beneficiary Notice of Noncoverage (ABN) is required when you expect Medicare to deny a K0077 claim as not reasonable and necessary. Give it to the beneficiary before the part is supplied, not after. Without a valid ABN, you cannot bill the beneficiary if Medicare denies payment.

Issue an ABN when the records do not clearly show that the caster needs replacing. Issue one too when the payer has denied a similar claim for this beneficiary before. Use form CMS-R-131 and keep a signed copy in the claim file.

Payer-specific K0077 policies beyond Medicare

Medicaid programs and commercial plans set their own rules for wheelchair repair parts, including prior authorization and quantity limits. Read the payer’s DME policy and code table before the first claim, and record the answer against the patient.

How Pabau keeps K0077 claims audit-ready

In many supplier offices, the order, the repair note and the claim live in three places. The billing team picks K0077, K0071 or K0072 from memory or a part number. When an auditor asks which tire was delivered, someone has to rebuild the answer from scattered files.

Pabau keeps those records on one patient file. The order, the delivery record and the claim sit together, and Pabau’s claims management software tracks the modifier on every line. Every Pabau subscription includes the full feature set, so documentation and billing share the same record.

The result is a claim that matches the part on the delivery record. Your team spends less time answering audit requests and resubmitting corrected claims.

Manage DMEPOS claims without the guesswork

Pabau’s claims management software tracks modifier requirements, links documentation to claims, and flags incomplete records before submission, so fewer K0077 claims come back denied.

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Conclusion

K0077 is a narrow code, and most of its denials come from treating it as a broad one. It pays for one solid-tire front caster assembly as a replacement, nothing more. If the tire was pneumatic or semi-pneumatic, the claim belongs to K0071 or K0072. If only a fork or wheel was replaced, it belongs to a component code.

The suppliers who get paid first time record the tire type at delivery and price the line with NU, UE or RR. Pabau’s claims management software keeps that record and the claim together. Book a demo to see how it works for DMEPOS billing teams.

Continue your research

Need a denial resolution framework for DMEPOS claims? Denial management in healthcare covers the full appeal workflow from CARC code to corrected claim.

Unclear on how clearinghouse submission works for HCPCS codes? Medical billing fundamentals explains the end-to-end claim lifecycle for DME suppliers.

Looking for a reference on billing compliance documentation? Medical billing compliance outlines the documentation standards Medicare auditors check on DMEPOS claims.

Billing a semi-pneumatic caster instead? HCPCS code K0072 covers the semi-pneumatic front caster assembly, with its own modifiers and documentation.

Filing the claim on paper? The CMS-1500 form template explains each field on the paper claim form.

Frequently asked questions