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E0472 Service Type Codes to Send

HCPCS code

Durable medical equipment

CMS description

Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)

Why these codes

Equipment is answered under DME; purchase, rental and used benefits differ by plan, so check the one you bill.

If a payer returns nothing

Payers don't all answer every service type. Send 30 (Health Benefit Plan Coverage) for the plan's general benefits.

Sources

CMS HCPCS Level II descriptor; X12 HIPAA 5010 service type code definitions; VerifyTX billing practice

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