Each year, in the United States, health care insurers process over 5 billion claims for payment. For Medicare and other health insurance programs to ensure that these claims are processed in an orderly and consistent manner, standardized coding systems are essential. The HCPCS & ICD 10 Code Sets are the standard code sets currently used for this purpose. While the sets are complex, the items we sell at CPAPX fall primarily into the categories listed below.
NOTE: One of the ways we keep overhead low and our prices down is by working directly with consumers rather than with HMOs, Medicare and insurance companies. Having said that, most companies will accept our itemized receipts for reimbursement purposes and we do provide our complete business information, Tax ID, and standard insurance product codes directly on each receipt.
ICD-10 DIAGNOSIS CODES FOR SLEEP, OXYGEN & ASTHMA THERAPY
Developed by the World Health Organization (WHO), the International Classification of Diseases (ICD) and its coding system provides critical information about epidemiology, managing health, and treating conditions. Healthcare professionals use ICD codes to record and identify health conditions; and insurance companies use them to identify and classify conditions on insurance claims. You can usually find the ICD10 (or the older ICD9) code for your condition listed on prescriptions or medical records. Below are common ICD-10 codes for diagnoses treated by products sold on this site.
| COMMON SLEEP & OXYGEN THERAPY DIAGNOSIS CODES (ICD10) | |
| G47.30 | Sleep Apnea (Unspecified) |
| G47.31 | Primary Central Sleep Apnea |
| G47.33 | Obstructive Sleep Apnea (Adult) (Pediatric) |
| G47.37 | Central Sleep Apnea in Conditions Classified Elsewhere |
| G47.39 | Other Sleep Apnea |
| J44.0 | Chronic Obstructive Pulmonary Disease (COPD) with Acute Lower Respiratory Infection |
| J44.1 | Chronic Obstructive Pulmonary Disease (COPD) with (Acute) Exacerbation |
| J44.9 | Chronic Obstructive Pulmonary Disease (COPD) (Unspecified) |
| J45.20 | Mild Intermittent Asthma (Uncomplicated) |
| J45.30 | Mild Persistent Asthma (Uncomplicated) |
| J45.40 | Moderate Persistent Asthma (Uncomplicated) |
| J45.50 | Severe Persistent Asthma (Uncomplicated) |
| J45.901 | Unspecified Asthma with (Acute) Exacerbation |
| J45.909 | Unspecified Asthma (Uncomplicated) |
HCPCS CODING REFERENCE
Many insurers require that HCPCS codes be included with any claim for medical devices, supplies or equipment. At cpapXchange we do not work directly with Medicare or insurance companies; however we do include the appropriate HCPCS codes for each item on every customer invoice to make submitting claims as quick and easy as possible. Below is a list of common HCPCS codes for the products sold on this site.
| CPAP/BiPAP MACHINE INSURANCE (HCPCS) CODES | |
| E0601 | Continuous airway pressure (CPAP/APAP) device |
| E0470 | Respiratory assist device, bi-level pressure (BiPAP) capability, WITHOUT backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
| E0471 | Respiratory assist device, bi-level pressure (BiPAP) capability, WITH backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
| E0472 | Respiratory assist device, bi-level pressure (BiPAP) capability, WITH backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device) |
| E0561 | Humidifier, non-heated, used with positive airway pressure (CPAP/BiPAP/APAP) device |
| E0562 | Humidifier, heated, used with positive airway pressure (CPAP/BiPAP/APAP) device |
| CPAP/BiPAP MASK INSURANCE (HCPCS) CODES | |
| A7030 | Full Face Mask used with Positive Airway Pressure (CPAP/BiPAP/APAP) Device |
| A7034 | Nasal interface (mask or cannula type) used with positive airway pressure (CPAP/BiPAP/APAP) device , with or without headstrap |
| A7044 | Oral interface used with positive airway pressure (CPAP/BiPAP/APAP) device |
| A7027 | Combination oral/nasal mask, used with continuous positive airway pressure device |
| CPAP/BiPAP PART & ACCESSORY INSURANCE (HCPCS) CODES | |
| A7028 | Replacement Oral Cushion for Combination Oral / Nasal Mask |
| A7029 | Replacement Nasal Pillows Cushion for Combination Oral / Nasal Mask |
| A7031 | Replacement Cushion for Full Face Mask |
| A7032 | Replacement Cushion for Nasal Mask |
| A7033 | Replacement Pillows for Nasal Pillows or Cannula Style Mask |
| A7035 | Headgear used with positive airway pressure device |
| A7036 | Chinstrap used with positive airway pressure device |
| A7037 | Tubing used with positive airway pressure device |
| A4604 | Heated Tubing used with positive airway pressure device |
| A7038 | Filter, disposable, used with positive airway pressure device |
| A7039 | Filter, non-disposable (reusable), used with positive airway presssure device |
| A7045 | Exhalation port with or without swivel used with accessories for positive airway pressure devices |
| A7046 | Water chamber for humidifier, used with positive airway pressure device |
| E1399 | Miscellaneous Durable Medical Equipment Items, Components and Accessories |
| ORAL DEVICE INSURANCE (HCPCS) CODES | |
| E0490 | Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote to describe eXciteOSA® with a remote |
| E0491 | Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply |
| K1028 | Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by phone application. |
| K1029 | Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by phone application, 90-day supply |
| NEBULIZER & COMPRESSOR INSURANCE (HCPCS) CODES | |
| E0570 | Nebulizer, with compressor |
| A7005 | Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
| A7004 | Small volume nonfiltered pneumatic nebulizer, disposable |
| A7003 | Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
| A7015 | Aerosol mask, used with dme nebulizer |
| A7014 | Filter, nondisposable, used with aerosol compressor or ultrasonic generator |
| A7013 | Filter, disposable, used with aerosol compressor or ultrasonic generator |
| A4627 | Chamber, with or without mask, for use with metered dose inhaler |
| OXYGEN CONCENTRATORS & SUPPLIES INSURANCE (HCPCS) CODES | |
| E1356 | Oxygen accessory, Battery pack |
| E1357 | Oxygen accessory, Battery charger |
| E1358 | Oxygen accessory, DC Power Adapter |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
| E1392 | Portable oxygen concentrator |
| E0445 | Oximeter device for measuring blood oxygen levels non-invasively |
| A4615 | Oxygen nasal cannula |
| A4616 | Oxygen supply tubing |
These codes are provided for your reference only and should be verified with your insurer to ensure accuracy. Different insurers have different rules and procedures for making successful claims. Please contact your insurer directly to determine which procedures you should follow to ensure a successful claim. To learn more about HCPCS codes visit the Centers for Medicare & Medicaid Services. To learn more about ICD codes visit the World Health Organization.
