Top 20 durable medical equipment procedure codes
There are over 500 Healthcare Common Procedure Coding System (HCPCS) codes for Durable Medical Equipment (DME) for patients’ every day and extended use. This equipment includes oxygen systems and accessories, canes, wheelchairs, crutches, infusion pumps and glucose monitors. As the incidence of chronic diseases increases, there will be a growing need for devices to support patients.
How many DME related procedures take place each year?
Based on data from the Definitive Healthcare ClaimsMx product, we reviewed the DME-related medical procedure codes for the last two years. Between 2019 and 2020, the total number of DME procedure claims increased from about 740,000 to just under 825,000. The following are the top DME procedure codes with the highest number of claims in 2020.
DME procedure codes with most claims in 2020
||Total Procedures 2020
||Total Procedures 2019
||Continuous positive airway pressure (CPAP) Device
||Crutches underarm, other than wood, adjustable or fixed pair, with pads, tips and handgrips
||Humidifier, heated, used with positive airway pressure (PAP) device
||Safety equipment, device or accessory, any type
||Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate
||Durable medical equipment, miscellaneous
||Nebulizer with compression
||Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface
||Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation
||Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing
||Respiratory suction pump, home model, portable or stationary, electric
||Parental infusion pump, stationary, single or multi-channel
||Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours
||Walker folding wheeled
||Cane adjust/fixed with tip
||Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment
||External ambulatory infusion pump
Fig. 1 Data from the Definitive Healthcare ClaimsMx product for calendar year 2019 and 2020. Commercial claims data is sourced from multiple medical claims clearinghouses in the United States and updated monthly. Data accurate as of October 2021.
Which DME procedure codes have the highest number of claims?
Codes for continuous positive airway pressure (CPAP) devices (E0601) top the DME list with over 233,000 claims – a 50% increase from 2019’s total of 155,000. Crutches (E0114) and humidifiers (E0562) complete the top three. Eight of the top 20 DME codes are related to respiratory needs including oxygen concentrators (E1390), nebulizers (E0570) and portable oxygen systems (E0431).
With the exception of non-invasive oximeters (E0445), which was 21st in 2019, the same DME codes appeared in the top 20 claims for both 2019 and 2020. Safety equipment (E0700) jumped the most spots – from 18th in 2019 to 4th in 2020 – potentially due to increased patient needs during the COVID-19 pandemic.
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