If you offer DME billing services, you know how difficult it can be to stay on top of the constantly changing codes. However, you may streamline your billing procedure and guarantee the highest possible reimbursement for your services if you have the correct information and tools.

In this article, we’ll go over some of the most typical DME billing HCPCS codes. By making use of these codes, you can not only save time but also increase the amount of reimbursement you receive.

Common DME Billing HCPCS Codes

The most popular HCPCS codes for DME billing services are shown below:

The HCPCS Codes

If a CPT code doesn’t explicitly cover a medical service or equipment, it can be described using an HCPCS code.  Since conventional HCPCS codes do not cover many DME items, these codes are frequently utilized for DME billing.

DME billing typically uses the following HCPCS codes:

• E0143: Walker that folds up and has wheels
• E0193: Heavy-duty walker with various brakes and adjustable wheel resistance
• E0277: Hospital bed with a mattress that is semi-electric
• E0431: Renting a portable gaseous oxygen system
• E0601: an equipment that delivers continuous positive airway pressure (CPAP)
• K0001: Typical wheelchair
• E0130: walkers, pick-up-folding, height-adjustable, or fixed
• E0140:  Wheeled or walking device, flexible or fixed-height
• E0150:  Gait trainer, pediatric size, and ambulatory assistance device
• E0181:  Pressure-relieving gel mattress pad
• E0199:  Non-specific DME, such as nebulizers, TENS units, and CPAP machines

Additional 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.

 

Conclusion

DMEs are required to enhance the quality of life and sustain patients’ freedom at home, but because of changing regulatory compliance, billing for orthotics and DME is changing.

Due to the high cost of these DMEs, physicians need to be familiar with the billing process for orthotics and DME. Lower reimbursements have an adverse effect on the management of your revenue cycle.