RETIRED - Oxygen Enriching Systems - Payment Information

IMPORTANT: THIS DOCUMENT CONTAINS OUTDATED INFORMATION.Content Provided on this page contains outdated information and instruction and should not be considered current. Noridian is providing this archived information for research purposes only. This archived article contains previously issued instructions that have since been updated or are no longer applicable for Medicare billing purposes.

Article retired due to content incorporation into the applicable Local Coverage Determination or related Policy Article.

Original Effective Date: 01/01/2001
Revision Effective Date: 11/01/2013

Codes E1405 and E1406 describe oxygen and water vapor enriching systems with or without heated delivery respectively. Due to their design, these devices require substantially higher oxygen flow rates in order to deliver the same concentration of oxygen as that achieved by standard oxygen delivery systems (for example, concentrators or liquid/gaseous systems). Since codes E1405 and E1406 require the higher flow rate but do not provide a benefit to the beneficiary in terms of the inspired concentration of oxygen, payment will not be made at the 150% of the Medicare fee schedule for these devices. The modifiers QF and QG, which are appended to claim lines to indicate oxygen flow rates greater than 4 liters/minute, must not be used with codes E1405 and E1406.

 

            Last Updated Thu, 10 Jan 2019 12:33:57 +0000