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HCPCS INSURANCE CODES* & PRESCRIPTION ITEMS


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Each year, in the United States, health care insurers process over 5 billion claims for payment. For Medicare and other health insurance programs to ensure that these claims are processed in an orderly and consistent manner, standardized coding systems are essential. The HCPCS Code Set is one of the standard code sets used for this purpose.

Many insurers require that HCPCS codes be included with any claim for medical devices, supplies or equipment. At DirectHomeMedical we include the appropriate HCPCS codes for each item on every customer invoice to make submitting insurance claims as quick and easy as possible.

The items we sell at DirectHomeMedical fall primarily into the Positive Airway Pressure Device categories listed below.


CPAP/BiPAP MACHINE INSURANCE (HCPCS) CODES

E0601 Continuous airway pressure (CPAP/APAP) device
E0470 Respiratory assist device, bi-level pressure (BiPAP) capability, WITHOUT backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)
E0471 Respiratory assist device, bi-level pressure (BiPAP) capability, WITH backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)
E0472 Respiratory assist device, bi-level pressure (BiPAP) capability, WITH backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)
E0561 Humidifier, non-heated, used with positive airway pressure (CPAP/BiPAP/APAP) device
E0562 Humidifier, heated, used with positive airway pressure (CPAP/BiPAP/APAP) device


CPAP/BiPAP MASK INSURANCE (HCPCS) CODES

A7030 Full Face Mask used with Positive Airway Pressure (CPAP/BiPAP/APAP) Device
A7034 Nasal interface (mask or cannula type) used with positive airway pressure (CPAP/BiPAP/APAP) device , with or without headstrap
A7044 Oral interface used with positive airway pressure (CPAP/BiPAP/APAP) device
K0553 Combination oral/nasal mask, used with continuous positive airway pressure device


CPAP/BiPAP PART & ACCESSORY INSURANCE (HCPCS) CODES

A7031 Replacement Cushion for Full Face Mask
A7032 Replacement Cushion for Nasal Mask
A7033 Replacement Pillows for Nasal Mask
A7035 Headgear used with positive airway pressure device
A7036 Chinstrap used with positive airway pressure device
A7037 Tubing used with positive airway pressure device
A7038 Filter, disposable, used with positive airway pressure device
A7039 Filter, non-disposable (reusable), used with positive airway presssure device
A7045 Exhalation port with or without swivel used with accessories for positive airway pressure devices
A7046 Water chamber for humidifier, used with positive airway pressure device
E1399 Miscellaneous Durable Medical Equipment Items, Components and Accessories
K0554 Oral cushion for combination oral/nasal mask
K0555 Nasal pillows for combination oral/nasal mask


LIGHT THERAPY DEVICE INSURANCE (HCPCS) CODES

E0203 Light Therapy Device


OXYGEN CONCENTRATORS & SUPPLIES INSURANCE (HCPCS) CODES

E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate
E1392 Portable oxygen concentrator
E0445 Oximeter device for measuring blood oxygen levels non-invasively
A4615 Oxygen nasal cannula
A4616 Oxygen supply tubing


* These codes are provided for your reference only and should be verified with your insurer to ensure accuracy. Different insurers have different rules and procedures for making successful claims. Please contact your insurer directly to determine which procedures you should follow to ensure a successful claim. To learn more about HCPCS codes visit the Centers for Medicare & Medicaid Services.






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