| Field Name |
Field Value |
| Healthcare Common Procedure Coding System Code |
E0791 |
| 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 |
Parenteral infusion pump, stationary, single or multi-channel |
| HCPCS Short Description |
Parenteral infusion pump sta |
| 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 |
65-10 |
| HCPCS Medicare Carriers Manual Reference Section Number 1 |
2130 |
| HCPCS Medicare Carriers Manual Reference Section Number 2 |
4450 |
| 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 |
1/1/1989 |
| HCPCS Action Effective Date |
1/1/1996 |
| HCPCS Action Code |
N - No maintenance for this code |