Question 1

What is HCPCS code E0461?

Accepted Answer

HCPCS code E0461 is "Vol control vent noninv int". Volume control ventilator, without pressure support mode, may include pressure control mode, used with non-invasive interface (e.g., mask)

Question 2

What category is E0461 in?

Accepted Answer

E0461 belongs to HCPCS Category E (Durable Medical Equipment (DME)).

Question 3

When should I use HCPCS code E0461?

Accepted Answer

Use E0461 when billing for vol control vent noninv int. 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 E0461 covered by Medicare?

Accepted Answer

Coverage for E0461 (Vol control vent noninv int) 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 E0461?

Accepted Answer

Documentation for E0461 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).