How confident are you about using the right DME codes? We all know that proper coding can save you from payment delays. But did you know that durable medical equipment (DME) is usually covered by the Healthcare Common Procedure Coding System (HCPCS) instead of CPT codes?
DMEs are primarily covered by HCPCS’ level II codes because they fall under the devices, products, and supplies category. These five-lettered alphanumeric codes typically begin with the letter E and report several essential items. So, whether you are a healthcare professional or a coding expert, you should know the common DME HCPCS codes to avoid claim denials.
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The Growing Demand for Durable Medical Equipment (DME)
Durable medical equipment, such as wheelchairs, hospital beds, oxygen tanks, and more, is essential for a large group of patients, including those with chronic conditions, senior citizens, and individuals recovering from surgeries.
According to the U.S. Centers for Disease Control and Prevention (CDC), chronic diseases are responsible for the majority of illnesses, disabilities, and deaths in the U.S. As these conditions become more prevalent, there is a growing need for support devices. Grand View Research highlights this in their latest report, estimating that the DME market, valued at approximately $63.14 billion last year, will grow at a CAGR of 5.63% till 2030.
As a result, anyone involved in the healthcare administration, billing department, or patient care should be aware of the most common DME HCPCS codes to achieve better operational and financial results.
Most Frequently Used HCPCS Codes for DME
Are you a healthcare provider who usually deals with chronic patients? Then you are at the right place! HCPCS level II codes, maintained and updated annually by the Centers for Medicare and Medicaid Services (CMS), are used to identify and report a wide range of durable medical equipment.
We have compiled a list of the most frequently used codes so you can improve your coding accuracy. However, keep in mind that insurance companies only cover these devices if they are medically necessary. So, always maintain proper documentation to qualify for timely reimbursements. Without further ado, here are some of the most commonly used HCPCS codes for DME.
DME HCPCS Codes for Walking Aids & Attachments
E0114 – Adjustable Non-Wood Underarm Crutches
The E0114 DME HCPCS code refers to a popular walking aid – a pair of underarm crutches. These crutches are usually made from non-wood materials and have either fixed or adjustable heights. These walking sticks are specifically for people who need support due to an injury or disability and come with pads, tips, and handgrips for comfort and stability. Billing specialists use this HCPCS code to claim reimbursements for providing mobility support.
E0143 – Folding Walker with Wheels
This DME HCPCS code addresses one of the walking aids – a folding walker with wheels. This walker has either an adjustable or fixed height. In simple terms, billing specialists use the E0143 HCPCS code to describe a walker designed to help patients move around more easily and safely. The unique thing about it is that it is easier to transfer and store when not in use because of its design.
E0156 – Seat Attachment for Walkers
This DME HCPCS code pertains to a walking aid accessory – seat attachment. To put it simply, billing specialists use the E0156 HCPCS code to address the order of an attachable seat for a walker, providing users with a place to rest when they take a much-needed break while walking. This add-on is ideal for patients with mobility issues or low stamina.
DME HCPCS Codes for Commode Chair & Supplies
E0163 – Commode Chair with Fixed Arms
This DME HCPCS code covers an important bathroom aid device. To be more specific, billing experts use the E0163 HCPCS code to address a mobile or stationary commode chair with fixed arms. This chair is helpful to those patients who find it difficult or painful to use a regular toilet.
DME HCPCS Codes for Hospital Beds & Associated Supplies
E0260 – Semi-Electric Hospital Bed
The E0260 DME HCPCS code points towards a semi-electric hospital bed with head and foot adjustments, side rails, and a mattress. This specialized bed is not only used in hospitals but is also recommended for in-home care, allowing patients or their caretakers to adjust the position of the head and feet using a remote control or button on the side.
DME HCPCS Codes for Oxygen Delivery Systems & Related Supplies
E0431 – Portable Gaseous Oxygen System (Rental)
This DME HCPCS code specifies a rented portable gaseous oxygen system. Designed to provide breathing support to patients, this system includes several key components, including:
- A portable container holding oxygen
- A regulator for controlling oxygen’s flow
- A flowmeter for measuring the amount of oxygen being delivered
- A humidifier for adding moisture
- Either a cannula or mask to deliver oxygen
- Necessary tubes to connect everything
Billing professionals use the E0431 HCPCS code to claim reimbursements for this complete gaseous oxygen system, available for short-term usage. This allows the patients to receive supplemental oxygen they need on the go.
E0466 – Home Ventilator with Non-Invasive Interface
The E0466 DME HCPCS code is also quite popular within this category. It covers a home ventilator with a non-invasive interface, such as a mask or chest shell. In simple words, this HCPCS code addresses a ventilator designed for patients who need breathing support at home. It assists them via non-invasive methods, like a mask that covers a patient’s nose and mouth. Hence, healthcare providers don’t have to insert tubes in their patients’ airways.
E0470 – Bi-Level Respiratory Assist Device (RAD)
This DME HCPCS code signifies a bi-level respiratory assist device – a machine that helps people with breathing difficulties. Here, bi-level refers to two levels of air pressure, one for inhaling and the other for exhaling. The E0470 HCPCS code especially refers to a non-invasive bi-level respiratory device without a backup rate feature.
This device only offers respiratory support and does not automatically initiate breathing. In simple words, healthcare providers use this machine on patients who can breathe on their own but don’t get enough oxygen.
DME HCPCS Codes for Humidifiers & Nebulizers
E0562 – Heated Humidifier for PAP Devices
The E0562 DME HCPCS code covers a heated humidifier used with a positive airway pressure (PAP) device. Healthcare professionals typically utilize heated humidifiers, also known as heated breathing circuits, along with ICU ventilators. These devices add warmth and moisture to the oxygen delivered to patients by the PAP machine.
Heated humidifiers are necessary for preventing dryness and irritation in a patient’s airways, allowing them to breathe more comfortably.
E0570 – Nebulizer with Compressor
Classified under Humidifiers and Nebulizers with Related Equipment, this DME HCPCS code is also quite popular. It reports a nebulizer – a device that transforms liquid into fine mist – with a compressor. The compressor actually helps with the transformation by pushing air through the liquid medication.
Billing professionals use the E0570 HCPCS code to refer to this device, allowing healthcare providers or suppliers to obtain payments for helping patients control breathing problems.
E0601 – Continuous Positive Airway Pressure (CPAP) Device
This DME HCPCS code refers to a Continuous Positive Airway Pressure (CPAP) device – a machine used to assist patients with breathing disorders during sleep, such as sleep apnea.
The CPAP machine uses mild air pressure to keep the airways open while a person sleeps. Billing experts essentially use the E0601 HCPCS code to bill for this type of machine, allowing healthcare providers to receive reimbursements.
DME HCPCS Codes for Breast Pumps
E0603 – Electric Breast Pump
This DME HCPCS code specifies an electric breast pump operating via either AC or DC power. Billing experts use the E0603 HCPCS code to notify payers about an electric device that helps mothers extract breast milk more comfortably and efficiently. This device is flexible and convenient for working mothers.
DME HCPCS Codes for Patient Lifts & Support Systems
E0630 – Hydraulic or Mechanical Patient Lift
The E0630 DME HCPCS code identifies one of the support systems for transferring patients from one place to another – a patient lift. This code refers to a hydraulic or mechanical patient lift, which includes an associated seat, sling, strap(s), or pad(s). Healthcare providers recommend this device because it is safer than relying on a caregiver to move patients. It helps reduce the physical strain on caregivers and the risk of patient injuries.
DME HCPCS Codes for Infusion Pumps & Supplies
E0781 – Ambulatory Infusion Pump
This DME HCPCS code covers an ambulatory infusion pump – a portable, electricity or battery-powered device that allows patients to go about their daily lives. DME suppliers or billing teams use the E0781 HCPCS code to file reimbursement for this specific pump that delivers medication or fluids directly into a patient’s body without hospitalization.
This IV pump can have single or multiple channels and typically arrives with all the essential administrative equipment. It is lightweight enough to be worn by patients or carried in a pouch. Healthcare providers usually recommend this device to patients with chronic or gastrointestinal conditions, infections, diabetes, or cancer.
DME HCPCS Codes for Wheelchair Accessories
E0971 – Anti-Tipping Device for Manual Wheelchairs
This DME HCPCS code informs payers about an anti-tipping accessory for manual wheelchairs. This device is usually attached to a wheelchair to improve its balance. In short, it provides additional patient safety by preventing wheelchairs from falling backward while going on an incline. Remember that the E0971 HCPCS code covers a single unit of this accessory.
E0973 – Adjustable & Detachable Armrest for Wheelchairs
The DME HCPCS code E0973 points toward another wheelchair accessory – an adjustable and detachable armrest. Simply put, this code refers to a complete armrest assembly that allows patients to adjust its height for better support and remove or reattach it if required. Like many other accessories, this attachment also provides additional comfort for wheelchair users.
E1028 – Wheelchair Accessory
The E1028 DME HCPCS code covers a wheelchair accessory providing flexibility to patients, including a manual swing away, retractable or mounting hardware for items like joystick and other control interfaces, or positioning accessories.
In simple words, this HCPCS code addresses all removable and adjustable wheelchair add-ons. This is especially beneficial for patients who frequently need to get in or out of the wheelchair or adjust their position for comfort.
DME HCPCS Codes for Oxygen Delivery Devices Accessories
E1390 – Oxygen Concentrator
The E1390 is a popular HCPCS code for DME. It refers to an oxygen concentrator – a medical device that separates nitrogen from oxygen. This HCPCS code specifically points towards a machine with a single delivery port, providing an oxygen concentration of 85% or higher at the prescribed flow rate by a healthcare provider.
Doctors usually prescribe this machine to patients who require breathing support.
E1392 – Portable Oxygen Concentrator (Rental)
Are you looking for a code that notifies payers about a rental transportable oxygen concentrator? E1392 can help you with that! This DME HCPCS code addresses a portable breathing assistance device available for rent. Billing experts use this HCPCS code to request reimbursement for short-term usage of an oxygen concentrator.
This allows suppliers and healthcare providers to ensure patients have access to portable oxygen for better breathing and mobility.
E1399 – Miscellaneous Durable Medical Equipment
This HCPCS code is quite unique. It refers to all the miscellaneous DMEs that do not fall within any category. In simple terms, you can use the E1399 DME HCPCS code for any oxygen delivery device or accessory that does not have a specific corresponding code.
Bottom Line
From oxygen delivery devices to walking aids, there is an increasing demand for durable medical equipment. These supportive devices aid patients with chronic conditions while improving their comfort and safety. Healthcare providers primarily use and recommend DMEs for medical purposes. The best part about them? They are reusable!
However, the billing process for these equipment and devices is not easy due to a large and complicated code set. While we cannot turn you into a coding expert overnight, we can help you improve your coding accuracy. We have identified and compiled the top 20 most frequently used HCPCS codes for DME to help your coding team.But if you are a complete beginner with limited resources, it is better to outsource DME billing services to avoid persistent claim denials. Several DME billing companies, including MediBill MD, can assist you with your coding problems. Identify the most suitable option and start receiving complete reimbursements on time.
