Prosthetics and Orthotics modifiers K0, K1, K2, K3,K4 and KF

Prosthetics and Orthotics

Many of the HCPCS codes in this category require the use of a K modifier. Reference the Lower Limb Prostheses policy for a listing of codes.

•    K0 Lower limb extremity prosthesis functional Level 0 - Does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance their quality of life or mobility
•    K1 Lower extremity prosthesis functional Level 1 - Has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. Typical of the limited and unlimited household ambulatory
•    K2 Lower extremity prosthesis functional Level 2 - Has the ability or potential for ambulation with the ability to traverse low level environmental barriers such as curbs, stairs, or uneven surfaces. Typical of the limited community ambulator
•    K3 Lower extremity prosthesis functional Level 3 - Has the ability or potential for ambulation with variable cadence. Typical of the community ambulator who has the ability to traverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion
•    K4 Lower extremity prosthesis functional Level 4 - Has the ability or potential for prosthetic ambulation that exceeds basic ambulation skills, exhibiting high impact, stress, or energy levels. Typical of the prosthetic demands of the child, active adult, or athlete




Osteogenesis Stimulators

E0747, E0748 and E0760 are Class III Devices that must be submitted with a KF modifier. The KF modifier indicates a FDA Class III Device.