Healthcare Insights

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 use.

What is durable medical equipment (DME)?

DME describes medical equipment and supplies ordered by a healthcare provider for a patient’s routine, long-term use. The coverage for DME may include 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.

Based on data from the Definitive Healthcare ClaimsMx product, we reviewed the DME codes for 2021. The following are the top DME procedure codes with the highest number of claims.

DME procedure codes with most claims in 2021

RankHCPCS codeHCPCS descriptionTotal procedures 2021Explore dataset
1E0601Continuous positive airway pressure (CPAP) device232,241Explore
2E0114Crutches underarm, other than wood, adjustable or fixed pair, with pads, tips and handgrips112,128Explore
3E0562Humidifier, heated, used with positive airway pressure (PAP) device59,553Explore
4E1390Oxygen concentrator28,333Explore
5E1399Durable medical equipment, miscellaneous24,381Explore
6E0604Hospital grade electric breast pump19,009Explore
7E0776IV pole18,530Explore
8E0470Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface17,684Explore
9E0570Nebulizer with compression17,155Explore
10E0730Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation16,872Explore
11E0143Walker folding wheeled14,823Explore
12E0486Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment14,043Explore
13E0431Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing13,653Explore
14E0791Parenteral infusion pump, stationary, single or multi-channel13,610Explore
15E0700Safety equipment12,680Explore
16E0100Cane adjust/fixed with tip11,673Explore
17E0600Respiratory suction pump, home model, portable or stationary, electric10,565Explore
18E0780Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours8,376Explore
19E0190Positioning cushion/pillow/wedge7,109Explore
20E0781Ambulatory infusion pump6,812Explore

Fig. 1 Data from the Definitive Healthcare ClaimsMx product for calendar year 2021. Claims data is sourced from multiple medical claims clearinghouses in the United States and updated monthly. Data accurate as of August 2022.

Which DME procedure codes have the highest number of claims?

Codes for continuous positive airway pressure (CPAP) devices (E0601) top the DME list with 232,000 claims. 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). The COVID-19 pandemic most likely contributed to the high number of claims for respiratory DME codes.

What types of DME does insurance cover?

While levels of insurance coverage vary based on payors, including Medicare and Medicaid coverage of DME, the main types of DME are:

  • Oxygen devices and accessories
  • Humidifier equipment
  • Walking aids      
  • Hospital beds and related supplies
  • Wheelchairs and mobility devices
  • Orthotics
  • Infusion supplies
  • Breast pumps

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