E0490 HCPCS - POWER SOURCE AND CONTROL ELECTRONICS UNIT FOR ORAL DEVICE/APPLIANCE FOR NEUROMUSCULAR ELECTRICAL STIMULATION OF THE TONGUE MUSCLE, CONTROLLED BY HARDWARE REMOTE

Code Information

HCPCS Code: E0490
Sequence Number: 0010
Short Description: Control unit nm hw remote
Long Description: Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote
Date Added: 10/1/2023
Action Code: N - No maintenance for this code
Action Effective Date: 10/1/2023
Classification: Durable Medical Equipment
Coding System: HCPCS

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:
N/A
Medicare Carriers Manual Reference Section Number:
N/A
Coverage Code: C - Carrier judgment

Field Name	Field Value
Healthcare Common Procedure Coding System Code	E0490
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	Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote
HCPCS Short Description	Control unit nm hw remote
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 Code	C - Carrier judgment
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	10/1/2023
HCPCS Action Effective Date	10/1/2023
HCPCS Action Code	N - No maintenance for this code