K Level Traits

What You Need to Know

When the DME MACs updated the Lower Limb Prostheses Policy Article in 2024, they added a list of traits characterizing K1-K4 individuals.

K1 Traits:

• Rely on wheelchair for most activities outside the home
• With/without an assistive device and/or the assistance/supervision of 1 person

- Has the cognitive ability to safely use a prosthesis

- Is capable of safe but limited home/similar surface ambulation

- Is not capable of most Level 2 functional activities

K2 Traits:

• With/without an assistive device and/or with/without the assistance/super-vision of one person, can

-Perform Level 1 tasks

-Walk on a flat, smooth surface (concrete/asphalt) found on a porch, deck, driveway)

-Negotiate a curb

-Access public or private transportation

-Negotiate 1-2 stairs

-Negotiate a ramp built to ADA specifications

• May require a wheelchair for distance beyond perimeters of the yard, driveway, apartment, etc.
• Only able to increase generally observed walking speed for short distances or with great effort
• Generally not capable of Level 3 tasks or can only do so infrequently with great effort

K3 Traits:

• With or without an assistive device, is individually capable of Level 2 tasks and can

-Walk on terrain that varies in texture and level (grass, gravel, uneven concrete)

-Negotiate 3-7 consecutive stairs

-Walk up/down ramps built to ADA specifications

-Open and close doors

-Ambulate through a crowded area (grocery store, big box store, restaurant)

-Cross a controlled intersection in their community within the time limit provided

-Access public or private transportation

-Perform dual ambulation tasks (carry an item or meaningfully converse while walking)

-Does not perform Level 4 activities

K4 Traits:

• With or without an assistive device, is independently capable of high impact activities like

-Running

-Repetitive stair climbing

-Climbing steep hills

-Caregiving for another individual

-Home maintenance (repairs, cleaning)

What This Means for You

You can use the traits listed for each K level as a documentation roadmap. When taking notes and reviewing them, ask whether they contain specific details corresponding to the above-listed traits. Generic statements like "patient is a K3 ambulator" are insufficient. Your notes should describe what the patient actually does or is expected to do that places them at that level.

You don't have to show every trait to satisfy a K level assignment. However, your documentation should generally show that the patient can perform equivalent activities.

To access the complete Lower Limb Prostheses Policy Article, including the current K level definitions and traits, click here.