| HCPCS Code: |
E1390 |
| Long Description: |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
| Short Description: |
Oxygen concentrator |
| Pricing Indicator 1: |
33 (Oxygen and oxygen equipment (price subject to floors and ceilings)) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| Coverage Issues Manual 1: |
60-4 |
| Statute Number: |
|
| Coverage Code: |
D (Special coverage instructions apply) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
D1C (Oxygen and supplies) |
| Type of Service Code 1: |
R (Rental of DME) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-01-2000 |
| Action Effective Date: |
01-01-2004 |
| Action Code: |
N (No maintenance for this code) |
