## **What is HCPCS code E1392?**
HCPCS code E1392 refers to a portable oxygen concentrator rental, a device prescribed for patients with chronic respiratory conditions who require supplemental oxygen. Unlike stationary oxygen equipment, this portable system allows mobility and independence while still delivering the oxygen needed to support daily activities.
The 36-month rental cap for oxygen concentrators was established under prior Medicare law, and suppliers must continue to furnish the equipment for the remainder of its reasonable useful lifetime once the rental period ends, provided medical necessity continues. The 21st Century Cures Act applies adjustments to Durable Medical Equipment, Prosthetic Devices, Prosthetics, Orthotics, & Supplies (DMEPOS) payment rules, including those for oxygen equipment.
Suppliers and providers should be aware of new and revised LCDs which require comment and notice, as local coverage determinations (LCDs) guide coverage indications, limitations, and documentation requirements. Updates to LCDs, along with their revision history effective date, may clarify the medical necessity section and outline any limitations and or medical necessity coverage rules. Some LCDs also reference a rest qualifying test or additional criteria to support medical necessity.
When billing for this code, providers must comply with coverage indications, limitations, and medical necessity requirements. Claims must demonstrate that the patient qualifies under current rules, as non-medical necessity coverage may result in denials. It’s also important to track whether services align with see break in service provisions, which may affect ongoing claims for oxygen concentrator rentals.
## **Documentation requirements**
To support billing for a portable oxygen concentrator rental, providers must ensure documentation is complete. Documentation should include:
- Results of a qualifying blood gas test or equivalent test and flow rate that confirms clinical need.
- Clear indication of oxygen flow rates, including any daytime and nighttime oxygen flow requirements, following standard arithmetic rounding rules when calculating averages.
- A documented flow requirement that supports coverage, such as a daytime at rest qualifying test or a nocturnal oxygen requirement standard.
- Confirmation that medical necessity is established through clinical notes and test results, consistent with the criteria in the coverage policy.
- Equipment details should specify whether the patient uses additional oxygen modalities, such as gaseous or liquid oxygen systems, or transfilling equipment for portable cylinders, in order to document all oxygen sources and support coverage determinations fully.
## **Billing requirements**
For proper claim submission of a portable oxygen concentrator, providers must follow payer rules, including Medicaid Services and Medicare coverage criteria. Billing requirements include:
- Initial claims for oxygen must document the qualifying blood gas test, test and flow rate, and a documented flow requirement such as a daytime at rest qualifying test or nighttime oxygen flow requirements.
- Use of standard arithmetic rounding rules applies when calculating an average documented flow requirement or a nocturnal oxygen requirement standard.
- Identify the correct HCPCS code (e.g., E0431, E0433, E0434, E1392) and list all related equipment or accessories, including gaseous or liquid oxygen systems, portable systems, transfilling equipment, or other covered oxygen supplies.
- The rental period for oxygen equipment is typically limited to 36 months, after which separate payment rules apply for oxygen contents (gas or liquid) and equipment.
## **Other relevant codes**
- **E0431** – Portable gaseous oxygen, rental
- **E0433** – Portable liquid oxygen, rental
- **E0434** – Portable liquid oxygen unit, refill
- **E1405** – Oxygen concentrator, portable, with delivery system
- **E1406** – Oxygen concentrator, portable, without delivery system]
Frequently asked questions
