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HCPCS Range Oxygen Delivery Systems and Related Supplies

• 1 Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing ( E0424 )

• 2 Stationary compressed gas system, purchase; includes regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing ( E0425 )

• 3 Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing ( E0430 )

• 4 Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing ( E0431 )

• 5 Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge ( E0433 )

• 6 Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing ( E0434 )

• 7 Portable liquid oxygen system, purchase; includes portable container, supply reservoir, flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adaptor ( E0435 )

• 8 Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing ( E0439 )

• 9 Stationary liquid oxygen system, purchase; includes use of reservoir, contents indicator, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing ( E0440 )

• 10 Oximeter device for measuring blood oxygen levels noninvasively ( E0445 )

• 11 Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories ( E0446 )

• 12 Oxygen tent, excluding croup or pediatric tents ( E0455 )

• 13 Chest shell (cuirass) ( E0457 )

• 14 Chest wrap ( E0459 )

• 15 Rocking bed with or without side rails ( E0462 )

• 16 Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) ( E0470 )

• 17 Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) ( E0471 )

• 18 Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device) ( E0472 )

• 19 Percussor, electric or pneumatic, home model ( E0480 )

• 20 Intrapulmonary percussive ventilation system and related accessories ( E0481 )

• 21 Cough stimulating device, alternating positive and negative airway pressure ( E0482 )

• 22 High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each ( E0483 )

• 23 Oscillatory positive expiratory pressure device, non-electric, any type, each ( E0484 )

• 24 Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment ( E0485 )

• 25 Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment ( E0486 )

• 26 Spirometer, electronic, includes all accessories ( E0487 )

• 27 Stationary oxygen contents, gaseous, 1 month's supply = 1 unit ( E0441 )

• 28 Stationary oxygen contents, liquid, 1 month's supply = 1 unit ( E0442 )

• 29 Portable oxygen contents, gaseous, 1 month's supply = 1 unit ( E0443 )

• 30 Portable oxygen contents, liquid, 1 month's supply = 1 unit ( E0444 )

• 31 Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) ( E0466 )

• 32 Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) ( E0465 )

• 33 Portable oxygen contents, liquid, 1 month's supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm) ( E0447 )

• 34 Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions ( E0467 )

• 35 Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote ( E0490 )

• 36 Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply ( E0491 )

• 37 Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by phone application ( E0492 )

• 38 Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by phone application, 90-day supply ( E0493 )

• 39 Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions ( E0468 )