2025 HCPCS code E0435
(Active) Effective Date: N/A Revision Date: N/A Durable Medical Equipment (DME) - Portable Liquid Oxygen Systems Oxygen Delivery Systems and Related Supplies Feed
Purchase of a portable liquid oxygen system, including container, reservoir, flowmeter, humidifier, gauge, cannula/mask, tubing, and refill adaptor.
Modifiers may apply depending on the circumstances; review payer-specific guidelines and consider modifiers for multiple procedures or unusual circumstances (e.g., if a modifier is required for specific patient circumstances, always ensure that the documentation supports the use of such modifiers).
Medical necessity must be established. This usually involves documenting the patient's respiratory condition, the need for supplemental oxygen, and the clinical rationale for selecting a portable oxygen system. ABG or pulse oximetry readings showing hypoxemia often provide evidence of medical necessity. The documentation must clearly demonstrate that the system is needed for the patient’s health and is not just for convenience.
Respiratory therapists or physicians may be involved in ordering, fitting, and educating patients on the use of the portable liquid oxygen system.The physician is responsible for determining medical necessity.
- Oxygen Delivery Systems and Related Supplies
- E0424-E0493 (Oxygen Delivery Systems and Related Supplies)
In simple words: This code covers buying a portable oxygen tank and all the parts that go with it:the tank itself, a device to control the oxygen flow, a humidifier to keep your nose from drying out, a tube to deliver oxygen to your nose or face, and an adapter to refill the tank.
HCPCS code E0435 represents the purchase of a portable liquid oxygen system.This system includes a portable container, supply reservoir, flowmeter to regulate oxygen flow, humidifier to prevent mucous membrane dryness, a contents gauge to monitor oxygen levels, a nasal cannula or mask for oxygen delivery, tubing connecting the components, and a refill adaptor for refilling the oxygen container. The system is designed for patients requiring supplemental oxygen while mobile.
Example 1: A 72-year-old male with COPD requires supplemental oxygen during daily activities.E0435 is used to bill for the purchase of the portable liquid oxygen system., A 65-year-old female with severe asthma experiences hypoxemia and needs portable oxygen therapy. E0435 is billed for the purchase of the system to improve her oxygen levels and quality of life., A 58-year-old patient recovering from pneumonia requires portable oxygen therapy during rehabilitation. The purchase of the portable liquid oxygen system is billed with E0435.
Documentation should include the diagnosis necessitating the use of portable oxygen therapy (e.g., COPD, asthma, pneumonia), physician's order specifying the need for the equipment, details of the system purchased (including model and manufacturer), and patient education on safe and proper use.Arterial blood gas (ABG) or pulse oximetry results are frequently required to demonstrate medical necessity.
** Always confirm with the specific payer for their coverage criteria and any additional requirements for reimbursement.
- Payment Status: Active
- Specialties:Pulmonology, Respiratory Therapy, Internal Medicine
- Place of Service:Office, Home Healthcare