Question 1

What is HCPCS code E0431?

Accepted Answer

HCPCS code E0431 is "Portable gaseous 02". Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing

Question 2

What category is E0431 in?

Accepted Answer

E0431 belongs to HCPCS Category E (Durable Medical Equipment (DME)).

Question 3

When should I use HCPCS code E0431?

Accepted Answer

Use E0431 when billing for portable gaseous 02. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is E0431 covered by Medicare?

Accepted Answer

Coverage for E0431 (Portable gaseous 02) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for E0431?

Accepted Answer

Documentation for E0431 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).