2025 HCPCS code E0424
(Active) Effective Date: N/A Revision Date: N/A Durable Medical Equipment - Oxygen Delivery Systems and Related Supplies E0424-E0493 Durable Medical Equipment E0100-E8002 Feed
Rental of a stationary compressed gaseous oxygen system.
Yes, modifiers such as QB and QF are applicable when prescribed oxygen flow exceeds 4 LPM. Other modifiers may apply depending on the circumstances.
Medical necessity must be established for DME coverage. The documentation should support the patient's need for supplemental oxygen and justify the use of a stationary system.
The provider must document the direct encounter and the condition necessitating the DME for the patient. Medicare covers the DME if documented as medically necessary.
In simple words: This covers renting a large oxygen tank for use at home. It includes the tank, the stuff inside, the parts that control the oxygen flow, a humidifier to keep the air moist, a nebulizer for medicine, and the mask or nosepiece.
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask and tubing.
Example 1: A patient with severe COPD requires supplemental oxygen at home and rents a stationary oxygen system., A patient recovering from pneumonia requires temporary oxygen therapy and rents a stationary system for use during convalescence., A patient with cystic fibrosis uses a nebulizer with the stationary oxygen system to administer inhaled medications.
Documentation must include the direct encounter, the medical condition requiring the oxygen, and the prescription for the DME. Justification for medical necessity should also be included.
** Prior authorization might be required. Ensure documentation supports the medical necessity for the prescribed oxygen flow rate and the type of equipment. Check with specific payers for coverage guidelines and any LCDs or NCDs.
- Payment Status: Active
- Specialties:Pulmonology, Respiratory Therapy, Internal Medicine, Family Medicine
- Place of Service:Home