E1391

Short Description

• Oxygen concentrator, dual

HCPCS Coverage Code

• D = Special coverage instructions apply

HCPCS Action Code

• N = No maintenance for this code

HCPCS Action Effective Date

• January 01, 2004

HCPCS Code Added Date

• January 01, 2004

HCPCS Pricing Indicator Code

• 33 = Oxygen and oxygen equipment (price subject to floors and ceilings)

HCPCS Multiple Pricing Indicator Code

• A = Not applicable as HCPCS priced under one methodology

HCPCS Coverage Issues Manual Reference Section Number

• 60-4

HCPCS Type Of Service Code

• R = Rental of DME

HCPCS Anesthesia Base Unit Quantity

• 0