Common HCPCS Insurance Codes & ICD 10 Diagnosis Codes for Sleep, Oxygen & Asthma Related Products


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.