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    v1.0.28
    OpenPayerBilling CodesDurable Medical EquipmentHCPCS hcpcs-e0470-bilevel-respiratory-assist-device-noninvasive
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    HCPCS Level II E0470: Bi-level Respiratory Assist Device, Noninvasive

    HCPCS Level II code E0470 describes a respiratory assist device with bi-level pressure capability used with a noninvasive interface (for example, nasal or facial mask); the service is intermittent respiratory assist therapy typically provided in the home or outpatient durable medical equipment setting using a bilevel positive airway pressure device without a backup rate feature.

    For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Prior Authorization for Durable Medical Equipment (DME), Breast Pumps.

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old male with severe obstructive sleep apnea (OSA) and persistent daytime hypersomnolence is evaluated in a sleep medicine clinic. After polysomnography demonstrates periods of hypoventilation and ineffective ventilation on CPAP, the sleep specialist prescribes a bilevel noninvasive ventilatory device without a backup rate feature for nocturnal use with a nasal or full-face mask. The durable medical equipment (DME) company performs device setup, mask fitting, patient education on nightly use and cleaning, and documents adherence and efficacy during a 30-day trial. Follow-up includes a clinic or home-based titration to optimize inspiratory and expiratory pressure settings, monitoring of usage data and oxygenation, and communication of results to the ordering clinician for ongoing coverage and clinical management. Typical site of service is the outpatient sleep clinic, durable medical equipment supplier, or the patient’s home during setup and monitoring visits.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    95810Polysomnography; sleep staging with continuous positive airway pressure (CPAP) titration, attended by a technologistPerformed prior to bilevel device selection for diagnosis and to guide pressure settings during in-lab titration.
    94660Continuous positive airway pressure ventilation (CPAP), initiation and managementRelated therapy initiation code for CPAP; used in workflow when trials compare CPAP to bilevel therapy or when transitioning therapies.
    94002Ventilation assist and management; initiation of non-invasive ventilatory support preoperative or in hospital setting (first day) — historical/illustrative; if unavailable in payer lists, use closest applicable ventilatory management codesUsed for initiation and management of ventilatory support in some practice settings; documents clinical management activities.
    99070Supplies and materials (e.g., surgical dressings, gloves), non-covered items; when not included with serviceUsed when additional nonstandard supplies or accessories related to the device are provided and not included in base equipment billing.
    99000Handling and/or conveyance of specimen for transfer from physician to laboratoryRarely applicable; include only if diagnostic samples were transported in connection with evaluation of ventilatory failure.

    Note: If any specific CPT codes are required by a payer for device-related professional services, those codes are reported in conjunction with the DME HCPCS code E0470 as clinically appropriate.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RH0000XHematology (Internal Medicine) PhysicianAn internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    3336C0002XClinic PharmacyA pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision o…
    247ZC0005XClinical Laboratory Director (Non-physician)An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments o…
    2080A0000XPediatric Adolescent Medicine PhysicianA pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and …
    335E00000XProsthetic/Orthotic SupplierAn organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design…
    246ZB0302XBiomedical PhotographerNone
    261QP2400XPrison Health Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center

    Related ICD-10-CM Codes

    30 rows

    ICD-10-CM CodeDescription
    E66.9Obesity, unspecified
    F51.01Primary insomnia
    F51.9Sleep disorder not due to a substance or known physiological condition, unspecified
    G47.10Hypersomnia, unspecified
    G47.30Sleep apnea, unspecified
    G47.31Primary central sleep apnea
    G47.33Obstructive sleep apnea (adult) (pediatric)
    G47.39Other sleep apnea
    G70.00Myasthenia gravis without (acute) exacerbation
    G70.01Myasthenia gravis with (acute) exacerbation

    Showing 1–10 of 30

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-10-01
    Breast PumpsModa Health2026-09-01
    Personal Emergency Response SystemsCareSource Georgia2026-09-01
    Continuous Passive Motion (CPM) DevicesCigna2026-08-15
    Push-Rim Activated Power-Assist Device (E0986) — Manual Wheelchair Accessorymoda_health_plan_inc2026-08-13
    Beds and Mattresses (for Ohio Only)Colorado Rocky Mountain Health Plans2026-08-01
    Beds and Mattresses (for Kentucky Only)UnitedHealthcare2026-08-01
    Pneumatic Compression Devices (for Nebraska Only)UnitedHealthcare2026-08-01
    Indications for Coverage — Hospital beds, support surfaces, and safety enclosure beds (DME)Colorado Rocky Mountain Health Plans2026-08-01

    Related Codes

    HCPCS-E0100-CANE-DURABLE-MEDICAL-EQUIPMENT-AMBULATION

    HCPCS E0100: Cane, Adjustable or Fixed, With Tip

    HCPCS-E0105-CANE-QUAD-THREE-PRONG-MOBILITY-AID

    HCPCS Level II E0105: Cane, Quad or Three-Prong, Includes Tips

    HCPCS-E0110-FOREARM-CRUTCHES-PAIR-DME-MOBILITY

    HCPCS Level II E0110: Forearm Crutches, Pair, Complete with Tips and Handgrips

    HCPCS-E0111-CRUTCH-FOREARM-DURABLE-MEDICAL-EQUIPMENT

    HCPCS Level II E0111: Crutch, Forearm, With Tip and Handgrips

    HCPCS-E0112-UNDERARM-WOOD-CRUTCHES-PAIR

    HCPCS Level II E0112: Underarm Wooden Crutches, Pair

    HCPCS-E0113-CRUTCH-UNDERARM-WOOD-ADJUSTABLE-FIXED-WITH-PAD-TIP-HANDGRIP

    HCPCS Level II E0113: Crutch Underarm, Wood, Adjustable or Fixed

    HCPCS-E0114-UNDERARM-CRUTCHES-PAIR-ADJUSTABLE-FIXED

    HCPCS Level II E0114: Underarm (Axillary) Crutches, Adjustable or Fixed, Pair

    HCPCS-E0116-UNDERARM-CRUTCH-NON-WOOD-ADJUSTABLE-FIXED

    HCPCS E0116: Underarm Crutch, Non-Wood, Adjustable/Fixed with Pad

    HCPCS-E0117-ARTICULATING-SPRING-ASSISTED-UNDERARM-CRUTCH

    HCPCS Level II E0117: Crutch, Underarm, Articulating, Spring-Assisted

    HCPCS-E0118-LOWER-LEG-PLATFORM-CRUTCH-SUBSTITUTE

    HCPCS E0118: Crutch Substitute, Lower Leg Platform

    Showing 1–10 of 670

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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