Insurance companies often require a product code called a HCPCS code for claims related to your CPAP purchases.
HCPCS (sometimes pronounced “hick-picks”) is an acronym for Healthcare Common Procedure Coding System and refers to the system of coding for services and equipment used by physicians, medical equipment suppliers, and insurance companies. Established in 1978, HCPCS is a national standard code set used by healthcare practitioners, providers and suppliers throughout the United States when filing insurance claims for drugs, medical devices, and other items and services. Medicare, Medicaid, and other health insurance programs use HCPCS to ensure that insurance claims are processed in an orderly and consistent manner.
HCPCS codes are broken down into two principal subsystems - Level I and Level II. Level I includes CPT codes established by the AMA to describe medical services and procedures, while Level II codes (also known as "DME codes") identify products, supplies, and some services that are not included in Level I.
Below is a detailed list of the CPAP-related HCPCS codes that your insurance company may need to quickly process your claim.
HCPCS - Description
E0601 - CPAP machine purchase
E0561 - CPAP Passover Humidifier
E0562 - CPAP Heated Humidifier
E0470 - BiPAP purchase
E0471 - BiPAP-ST purchase
A7034 - CPAP nasal mask
A7032 - CPAP nasal mask cushion
A7030 - CPAP Full Face mask
A7031 - CPAP Full Face mask cushion
A7044 - CPAP Full Oral Interface
A7046 - CPAP Humidifier Chamber
A4604 - CPAP tubing, heated breathing tube
A7037 - CPAP tubing, long and short hoses
A7038 - CPAP disposable filter
A7039 - CPAP foam filter
A7035 - CPAP headgear
A7033 - CPAP nasal pillows
A7036 - CPAP chinstrap
E1399 - CPAP Miscellaneous
E1390 - Oxygen Concentrator
A4616 - Oxygen Tubing
A4615 - Nasal Cannula