E0440 Stationary Liquid Oxygen System Reimbursement | OpenPayer

Summary & Overview

HCPCS E0440: Stationary Liquid Oxygen System, Purchase

HCPCS Level II code E0440 covers the purchase of a stationary liquid oxygen system that includes the reservoir, contents indicator, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing. As a durable medical equipment (DME) code, E0440 matters nationally because it defines coverage and billing for long-term oxygen therapy delivered in the home or other residential settings, influencing access for patients with chronic respiratory conditions and shaping payer DME policy and reimbursement practices. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will learn what E0440 represents clinically and operationally, which payers typically cover purchases of stationary liquid oxygen systems, and the types of benchmarks and policy context relevant to DME oxygen delivery. The summary highlights clinical context for home oxygen use, common sites of service, and where to find payer coverage details. Data not available in the input is noted where specific benchmarks, associated taxonomies, ICD-10 diagnoses, and related codes would normally appear.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareE0440HCPCS Level IIdurable medical equipmenthome oxygen therapystationary liquid oxygenDME billingrespiratory careoxygen concentrator alternative

Billing Code Overview

HCPCS Level II code E0440 describes a stationary liquid oxygen system, purchased by the provider. The supply includes use of a reservoir, contents indicator, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing. This represents a durable medical equipment (DME) item intended to provide long-term oxygen therapy for patients with chronic respiratory insufficiency.

Service Type: Durable Medical Equipment (DME), home oxygen therapy system

Typical Site of Service: Patient's home or long-term residential setting where stationary oxygen is required

Clinical & Coding Specifications

Clinical Context

A 72-year-old patient with advanced chronic obstructive pulmonary disease (COPD) and chronic hypoxemic respiratory failure is evaluated in the pulmonary clinic for long-term oxygen therapy. The patient requires continuous supplemental oxygen at home and is prescribed a stationary liquid oxygen system to support mobility within the residence and provide high-flow oxygen needs overnight. The typical clinical workflow: the pulmonologist documents oxygen dependence with resting oxygen saturation ≤88% on pulse oximetry or arterial blood gas demonstrating PaO2 ≤55 mmHg (or 56–59 mmHg with cor pulmonale or erythrocytosis), writes a detailed order specifying the stationary liquid oxygen system and liter flow requirements, and completes supporting documentation (face-to-face visit note, oxygen qualification testing, start date, and medical necessity rationale). The durable medical equipment (DME) supplier arranges delivery and setup in the patient’s home, provides patient education on device operation and safety, and records device serial numbers and delivery date. Follow-up visits document ongoing need, and equipment servicing or repairs are coordinated through the supplier as clinically indicated.

Coding Specifications

Modifier	Description	When to Use
`00`	Default/No modifier	Standard reporting when no other modifier applies.

HCPCS E0660: Non‑segmental Full‑Leg Pneumatic Compression Appliance

HCPCS-E0441-STATIONARY-OXYGEN-GASEOUS-1-MONTH-SUPPLY

HCPCS E0441: Stationary Gaseous Oxygen, 1-Month Supply

HCPCS-E2389-FOAM-CASTER-TIRE-POWER-WHEELCHAIR-REPLACEMENT

HCPCS E2389: Power Wheelchair Foam Caster Tire, Replacement Only

HCPCS-E0748-OSTEOGENESIS-STIMULATOR-ELECTRICAL-SPINAL

HCPCS Level II E0748: Osteogenesis Stimulator, Electrical, Spinal Applications

HCPCS-E0671-SEGMENTAL-GRADIENT-PRESSURE-PNEUMATIC-APPLIANCE-FULL-LEG

HCPCS E0671: Segmental Gradient Pressure Pneumatic Appliance, Full Leg

HCPCS-E0171-COMMODE-CHAIR-SEAT-LIFT-NON-ELECTRIC

HCPCS Level II E0171: Commode Chair with Integrated Non-Electric Seat Lift

HCPCS-E0986-POWER-ASSIST-SYSTEM-MANUAL-WHEELCHAIR-ACCESSORY

HCPCS E0986: Manual Wheelchair Accessory, Power Assist System

HCPCS-E0978-WHEELCHAIR-POSITIONING-SAFETY-BELT-PELVIC-STRAP

HCPCS Level II E0978: Wheelchair Positioning/Safety Belt

HCPCS-E1405-OXYGEN-WATER-VAPOR-ENRICHING-HEATED-DELIVERY

HCPCS E1405: Oxygen and Water Vapor Enriching System with Heated Delivery

HCPCS-E2218-FOAM-PROPULSION-TIRE-WHEELCHAIR-ACCESSORY

HCPCS E2218: Manual Wheelchair Foam Propulsion Tire, Each

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Taxonomy Code	Specialty	Notes
`207RP1000X`	Pulmonology	Pulmonologists commonly order and document long-term oxygen therapy.
`207RC0000X`	Critical Care Medicine	Intensivists may initiate oxygen therapy during hospitalization prior to transition to home DME.
`363L00000X`	Respiratory Therapist	Respiratory therapists perform oxygen qualification testing, equipment setup, and patient education (often employed by DME suppliers).
`261QM0800X`	Family Medicine	Primary care clinicians frequently manage chronic oxygen therapy prescriptions and follow-up documentation.
`2084P0800X`	Internal Medicine	Internists manage long-term oxygen needs and coordinate DME prescriptions.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`J44.0`	Chronic obstructive pulmonary disease with acute lower respiratory infection	COPD exacerbation episodes often precipitate evaluation for long-term oxygen therapy.
`J44.1`	Chronic obstructive pulmonary disease with (acute) exacerbation	Recurrent exacerbations may lead to chronic hypoxemia and need for stationary oxygen systems.
`J96.11`	Chronic respiratory failure with hypoxia	Direct indication for long-term supplemental oxygen and stationary liquid oxygen system purchase.
`I27.9`	Pulmonary heart disease, unspecified	Cor pulmonale related to chronic lung disease supports criteria for oxygen therapy qualification.
`R09.02`	Hypoxemia	Objective documentation of low oxygen saturation is central to medical necessity for oxygen equipment.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`94002`	Ventilation assist and management, initiation of pressure or volume preset ventilator for assisted or controlled breathing; hospital inpatient/observation, initial day	Performed when patients require transition from inpatient ventilatory support to home oxygen systems; documents advanced respiratory support needs prior to DME order.
`94640`	Pressurized or nonpressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposes (e.g., nebulized medication)	May be billed for nebulizer treatments provided during training or education sessions when demonstrating use with the stationary oxygen system, where medical necessity is documented.
`94760`	Noninvasive ear or pulse oximetry for oxygen saturation; single determination, spot check	Used to document oxygen saturation measurements that support medical necessity for stationary oxygen purchase.
`99214`	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	Typical visit level for documenting chronic hypoxemia, oxygen qualification testing, and writing the DME order for a stationary liquid oxygen system.
`99070`	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or other services rendered (list separately in addition to code for office visit)	May be used sparingly to report additional educational materials or supplies provided during the visit, subject to payer rules.

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