HCPCS Code E1358

Official Description

Oxygen accessory, dc power adapter for portable concentrator, any type, replacement only, each

Short Descr	Dc power adapter, port conc
Coverage	Special coverage instructions apply
Pricing Indicator(s)	00 – Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
MPI	9 – Not applicable, as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
Processing Note	NCD 240.2.
BETOS	D1C – Oxygen and supplies
TOS Code(s)	A – Used durable medical equipment (DME)
Added Date	1/1/2009
APC Status Indicator	Non-Implantable Durable Medical Equipment
MUE	0
MUE	0
OTS Orthotic	No
CCS Clinical Classification	243 - DME and supplies

GY	Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
KX	Requirements specified in the medical policy have been met
NU	New equipment
RR	Rental (use the 'rr' modifier when dme is to be rented)