E0472 HCPCS - 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)

Code Information

HCPCS Code: E0472

Sequence Number: 0010

Short Description: Rad w backup invasive intrfc

Long 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)

Code Added Date: 1/1/2004

Action Code: N - No maintenance for this code

Action Effective Date: 4/1/2006

Classification: Durable Medical Equipment

Coding System: HCPCS

Code Type

Berenson-Eggers Type Of Service Code: D1E - Other DME
Type Of Service Code:
  • R - Rental of DME

Billing Information

Pricing Indicator Code:
  • 36 - Capped rental DME (price subject to floors and ceilings)
Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
Coverage Issues Manual Reference Section Number:
  • 60-9
Medicare Carriers Manual Reference Section Number:
    N/A
    Coverage Code: D - Special coverage instructions apply

    HCPCS Record

    Field Name Field Value
    Healthcare Common Procedure Coding System Code E0472
    HCPCS Sequence Number 0010
    HCPCS Record Identification Code 3 - First line of procedure record also contains detail information in positions 92-275
    HCPCS Long 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)
    HCPCS Short Description Rad w backup invasive intrfc
    HCPCS Pricing Indicator Code 1 36 - Capped rental DME (price subject to floors and ceilings)
    HCPCS Multiple Pricing Indicator Code A - Not applicable as HCPCS priced under one methodology
    HCPCS Coverage Issues Manual Reference Section Number 1 60-9
    HCPCS Coverage Code D - Special coverage instructions apply
    HCPCS Berenson-Eggers Type Of Service Code D1E - Other DME
    HCPCS Type Of Service Code 1 R - Rental of DME
    HCPCS Anesthesia Base Unit Quantity 0
    HCPCS Code Added Date 1/1/2004
    HCPCS Action Effective Date 4/1/2006
    HCPCS Action Code N - No maintenance for this code

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    This page was last updated on: 1/1/2018