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HCPCS Level II Table of Contents

E1352 - E1406  Additional Oxygen Related Equipment

E1352
Oxygen accessory, flow regulator capable of positive inspiratory pressure
shortO2 flow reg pos inspir press
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME0.03 Date of Service Edit: ClinicalCMS Policy
E1353
Regulator
shortOxygen supplies regulator
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME0.03 Date of Service Edit: ClinicalCMS Policy
E1354
Oxygen accessory, wheeled cart for portable cylinder or portable concentrator, any type, replacement only, each
shortWheeled cart, port cyl/conc
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME0.03 Date of Service Edit: ClinicalCMS Policy
E1355
Stand/rack
shortOxygen supplies stand/rack
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME0.03 Date of Service Edit: ClinicalCMS Policy
E1356
Oxygen accessory, battery pack/cartridge for portable concentrator, any type, replacement only, each
shortBatt pack/cart, port conc
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME0.03 Date of Service Edit: ClinicalCMS Policy
E1357
Oxygen accessory, battery charger for portable concentrator, any type, replacement only, each
shortBattery charger, port conc
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME0.03 Date of Service Edit: ClinicalCMS Policy
E1358
Oxygen accessory, dc power adapter for portable concentrator, any type, replacement only, each
shortDc power adapter, port conc
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME0.03 Date of Service Edit: ClinicalCMS Policy
E1372
Immersion external heater for nebulizer
shortOxy suppl heater for nebuliz
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.03 Date of Service Edit: ClinicalNature of Equipment
E1390
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate
shortOxygen concentrator
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E1391
Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each
shortOxygen concentrator, dual
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E1392
Portable oxygen concentrator, rental
shortPortable oxygen concentrator
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Service/Procedure
E1399
Durable medical equipment, miscellaneous
shortDurable medical equipment mi
MUE
LocationValueAjudication IndicatorRationale
PRA1.03 Date of Service Edit: ClinicalClinical: CMS Workgroup
OPH0.03 Date of Service Edit: ClinicalCMS Policy
E1405
Oxygen and water vapor enriching system with heated delivery
shortO2/water vapor enrich w/heat
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment
E1406
Oxygen and water vapor enriching system without heated delivery
shortO2/water vapor enrich w/o he
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH0.03 Date of Service Edit: ClinicalCMS Policy
DME1.02 Date of Service Edit: PolicyNature of Equipment