HCPCS Code E0676: Intermittent Limb Compression Device (Includes All Accessories), Not Otherwise Specified

Read about HCPCS code E0676 for intermittent limb compression devices, coverage rules, billing, and documentation essentials.

Use Code

## **What is E0676?** HCPCS code E0676 describes an intermittent limb compression device (includes all accessories), not otherwise specified. These devices are a type of pneumatic compression device designed to prevent and treat conditions such as deep venous thrombosis (DVT), chronic venous insufficiency, lymphedema, and venous stasis ulcers. Unlike calibrated gradient pressure systems, devices under E0676 may be non-segmental pneumatic appliances or simplified home models, using compressed air delivered through inflatable garments that wrap around the lower extremities. They work by intermittently inflating and deflating chambers to mimic the body’s natural blood flow, promoting circulation in patients with arterial insufficiency, peripheral artery disease, or those at risk for venous thromboembolism. Because this code includes “all accessories, not otherwise specified,” suppliers may provide garments such as half-leg or full-leg inflatable sleeves, tubing, and electrical pneumatic pumps under this code when no more specific HCPCS code exists. This code is commonly referenced in Medicare and Medicaid services policies, local coverage determinations (LCDs), and national coverage determinations (NCDs), particularly for the Medicare population requiring home-based therapy with intermittent pneumatic compression. Coverage generally depends on the patient’s medical necessity, documented diagnosis, and compliance with clinical guidelines.

## **Documentation requirements** Documentation for E0676 intermittent limb compression devices must clearly establish medical necessity and confirm the patient’s clinical need for a non-segmental home model. Because this is a miscellaneous DME supply code, payers often require additional details to justify coverage. Key documentation elements: ### **Clinical indications** Documentation must show that the patient has conditions such as deep vein thrombosis (DVT), chronic venous insufficiency, or lymphedema that benefit from intermittent pneumatic compression therapy. Notes should specify whether a unilateral and bilateral system is required and include justification for a bilateral system when prescribed. ### **Device specifications** The record should describe the type of device provided, including whether it is a high-pressure or non-segmental home model. Details about accessories, such as garments, tubing, or electrical pneumatic pumps, should be included. ### **Service components** Because E0676 bundles the device and its service component, documentation should confirm what was provided. If accessories are billed separately under another code, the notes must explain why they fall outside the inclusive scope of E0676. In most cases, however, the device and accessories are not billed separately under this code. ### **Coverage support** Providers must maintain detailed clinical records, including progress notes and therapy history, to demonstrate that conservative measures were attempted before resorting to pneumatic compression. Supporting documents may include physician orders, diagnosis codes, and treatment plans that demonstrate the therapy is consistent with coverage guidelines.

## **Billing requirements** - **Unit of service**: Bill 1 unit = one device, since the code already includes all accessories. - **Diagnosis codes**: Claims must include a valid ICD-10-CM diagnosis demonstrating medical necessity. Examples include: I87.2 – Venous insufficiency (chronic, peripheral) and I89.0 – Lymphedema, not elsewhere classified. Coverage is tied to whether the condition meets criteria under local or national coverage determinations (LCD/NCD). - **Coverage**: Medicare and many commercial payers cover E0676 intermittent limb compression devices only if criteria for medical necessity are met, including documentation that standard therapies failed. - **Conservative therapy first**: Most payers require documentation of failed conservative therapy, such as compression garments or limb elevation, before approving a pneumatic compression device. - **Prior authorization**: Some payers, including state Medicaid programs and commercial insurers, may require prior authorization. Providers should always check payer-specific guidelines. - **Supporting documentation**: Ensure that claims include physician orders, medical records, and evidence of conservative therapy attempts. Missing documentation is a common cause of claim denials.

## **Other relevant codes** - **E0650** – Pneumatic compressor, non-segmental home model - **E0651** – Pneumatic compressor, segmental home model without calibrated gradient pressure - **E0652** – Pneumatic compressor, segmental home model with calibrated gradient pressure - **E0675** - Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)

Frequently asked questions

Unlike other compression device codes, E0676 is a miscellaneous “not otherwise specified” (NOS) code. It applies when a device or accessory does not fit into defined categories, such as non-segmental or calibrated gradient pressure models.

Yes. Compression stockings are often the first step, but if they are ineffective or contraindicated, E0676 may be approved as a medically necessary alternative or adjunct therapy.

E0675 is a high-pressure pneumatic compression device for arterial insufficiency with rapid inflation and deflation cycles, while E0676 is a general code for intermittent limb compression devices that do not fit a more specific HCPCS description.