This blog is designed to provide a comprehensive guide to coding for durable medical equipment (DME) services. Here, you will find detailed information on the coding process, including the specific codes used for DME, how to correctly apply them, and how to avoid common coding errors. We will also provide helpful tips and resources to make the billing process easier and more efficient. Even if you are a new or experienced coder, this blog will help you ensure accurate and compliant billing for DME services.
UNDERSTANDING COMMON HCPCS CODES
CPT codes do not always cover medical services or equipment, so HCPCS codes are used to describe them. This is especially true for DME items, as conventional CPT codes do not cover them, so HCPCS codes are often employed for DME billing.
DME BILLING TYPICALLY USES THE FOLLOWING HCPCS CODES
E0143: Walker that folds up and has wheels
E0193: This code refers to a heavy-duty walker with various brakes and adjustable wheel resistance for additional support and safety.
E0277: This code refers to a semi-electric hospital bed, meaning that it can be adjusted electronically in some ways but not others. It comes with a mattress.
E0431: This code refers to the rental of a portable gaseous oxygen system, which provides oxygen to a person with a medical condition who requires supplemental oxygen therapy.
E0601: equipment that delivers continuous positive airway pressure (CPAP)
K0001: This is an HCPCS code for a typical manual wheelchair. It describes a standard, basic wheelchair with no special features or modifications.
E0130: This code describes a type of walker that can be folded up for storage or transport and has adjustable height settings to accommodate different users. It can be either a wheeled or a standard walker with no wheels.
E0140: his code describes a walking aid device that can be either wheeled or non-wheeled and have a fixed or flexible height. Examples include crutches, canes, and quad canes.
E0150: E0150 is an HCPCS code for a pediatric-sized gait trainer, a mobility device designed to assist children with walking and improving their gait patterns. It is typically used for those with neurological or musculoskeletal impairments.
E0181: E0181 is an HCPCS code for a pressure-relieving gel mattress pad, durable medical equipment (DME) used to reduce pressure and prevent skin breakdown for patients who spend extended periods in bed or have limited mobility.
E0199: E0199 is an HCPCS code for non-specific DME, such as nebulizers, TENS units, and CPAP machines. This code is used for DME items that do not have a specific code assigned to them. These items are typically used to manage chronic medical conditions or improve mobility and quality of life.
ADDITIONAL COMMON CPT CODES
97750: Tests or measurements of physical ability (such as musculoskeletal or functional capacity) with a written analysis
97810: One or more needles are used in acupuncture, but no electrical stimulation exists. The first 15 minutes are spent talking to the patient individually.
97811: Acupuncture, which uses one or more needles without electricity, takes an extra 15 minutes of one-on-one time with the patient for each needle.
97530: The utilization of dynamic activities to enhance functional performance during therapeutic activities and one-on-one patient contact by the provider
97110: therapeutic activities that increase mobility, range of motion, and strength
HME SUPPLIES AND EQUIPMENT
A9270: For DME supplies without a specified HCPCS code, the billing code A9270 is utilized. Bandages, gauze, and catheters are among the goods that can be used with this code.
E0100: The billing code for a cane is E0100. Standard canes, quad canes, and specialty canes are all covered under this code.
E0260: A hospital bed is billed for using the code E0260. Both partially and entirely electrified hospital beds are covered under this code.
E0431: The billing code for a portable oxygen concentrator is E0431. This code applies to tools that give people who require on-the-go oxygen therapy.
E0434: The billing code for a stationary oxygen concentrator is E0434. The device this category covers delivers oxygen therapy to people who require it at home.
E1399: E1399 is a generic code used to bill for additional DME products without a unique HCPCS number. This code can be used for walkers, shower chairs, and commodes.
ORTHOTICS AND PROSTHETICS
L0112: The billing code for a cervical collar is L0112. This code covers collars used to immobilize the neck, soft or stiff.
L0631: The billing code for a back brace is L0631. This code covers semi-rigid and rigid back braces.
L1830: The billing code for a knee brace is L1830. Knee immobilizers, knee orthotics, and knee sleeves are all covered by this code.
L4360: The billing code for a walking boot is L4360. Boots used to immobilize the ankle or foot are covered by this classification.
L4396: The billing code for a wrist brace is L4396. This code applies to wrist immobilization braces.
In conclusion, DME coding is an essential part of accurate billing. It is important to understand the basics of DME coding, such as the HCPCS codes, modifiers, and the correct coding for various types of DME. With the proper knowledge and understanding, you can ensure that your DME billing is accurate and compliant with all applicable laws and regulations.