E1358 DC Power Adapter HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS E1358: DC Power Adapter for Portable Oxygen Concentrator, Replacement Only

HCPCS Level II code E1358 represents a replacement DC power adapter for portable oxygen concentrators, an accessory classified under durable medical equipment. This code matters nationally because portable oxygen concentrators are widely used for chronic respiratory conditions, and standardized coding for replacement accessories affects billing consistency, claims processing, and access to necessary power components that enable ambulatory oxygen use.

Key payers included in this review are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what E1358 covers, how it is typically billed in outpatient and home settings, and the types of documentation and service lines commonly associated with durable medical equipment accessory claims. The publication summarizes common modifiers and payer variation in coverage determinations where available, and it identifies gaps where specific payer policy language or pricing benchmarks are not provided.

This executive summary orients clinical staff, billing professionals, and policy analysts to the clinical context of portable oxygen concentrator accessories, the service setting for replacement items, and the administrative considerations that affect reimbursement and claim adjudication. Data not available in the input is noted where specific payer policies, taxonomies, ICD-10 linkages, and related codes would normally be detailed.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareE1358HCPCS Level IIdurable medical equipmentportable oxygen concentratoroxygen accessoryreplacement parthome oxygen therapybilling

Billing Code Overview

HCPCS Level II code E1358 describes an oxygen accessory: DC power adapter for portable concentrator, any type, replacement only, each. The service type is durable medical equipment (accessory/replacement part) provided when a replacement DC power adapter is supplied for a portable oxygen concentrator. The typical site of service is home or other outpatient/non-facility settings where patients use portable oxygen concentrators and require replacement power accessories.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A home oxygen therapy patient uses a portable oxygen concentrator and reports that the DC power adapter for vehicle or off-grid use is lost or malfunctioning. The durable medical equipment (DME) supplier receives a replacement order for a DC power adapter that is billed as E1358 (Oxygen accessory, dc power adapter for portable concentrator, any type, replacement only, each). Typical workflow: clinician documents ongoing need for portable oxygen therapy (for example, chronic hypoxemia due to COPD or interstitial lung disease) and writes a DME order specifying replacement of the DC power adapter. The supplier verifies patient eligibility and the original concentrator make/model to ensure compatibility, obtains any required prior authorization from the payor, and dispenses the adapter. Billing is submitted by the DME supplier to the patient’s commercial or government payor using HCPCS code E1358. Typical site of service is the patient’s home or the supplier’s outpatient dispensing location; the accessory is used with a portable oxygen concentrator during travel, vehicle use, or when AC mains power is unavailable. Common clinical scenario: an established patient on long-term oxygen therapy (LTOT) traveling by automobile requires a replacement vehicle DC adapter after the original was damaged, and the adapter is provided as a non-routine replacement item billed under E1358.

Coding Specifications

Modifier	Description	When to Use

HCPCS E0251: Hospital Bed, Fixed Height with Side Rails (No Mattress)

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

HCPCS E0671: Segmental Gradient Pressure Pneumatic Appliance, Full Leg

HCPCS-E2611-WHEELCHAIR-BACK-CUSHION-WIDTH-LESS-THAN-22IN

HCPCS E2611: Wheelchair Back Cushion, Width <22 inches

HCPCS-E0679-NON-PNEUMATIC-SEQUENTIAL-COMPRESSION-HALF-LEG

HCPCS E0679: Non-pneumatic Sequential Compression Garment, Half Leg

HCPCS-E2606-POSITIONING-WHEELCHAIR-SEAT-CUSHION-22-INCH-PLUS

HCPCS E2606: Positioning Wheelchair Seat Cushion, Width 22 Inches or Greater

HCPCS-E0187-WATER-PRESSURE-MATTRESS-HOME-DME

HCPCS Level II E0187: Water Pressure Mattress

HCPCS-E0112-UNDERARM-WOOD-CRUTCHES-PAIR

HCPCS E0112: Underarm Wooden Crutches, Pair, with Pads and Handgrips

HCPCS-E2220-WHEELCHAIR-SOLID-PROPULSION-TIRE-REPLACEMENT

HCPCS E2220: Manual Wheelchair Solid Propulsion Tire, Replacement Only

HCPCS-E1233-PEDIATRIC-TILT-IN-SPACE-WHEELCHAIR-RIGID

HCPCS Level II E1233: Pediatric Tilt-in-Space Rigid Wheelchair

HCPCS-E0683-PERISTALTIC-WAVE-COMPRESSION-PUMP

HCPCS Level II E0683: Peristaltic Wave Compression Pump

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Taxonomy Code	Specialty	Notes
261QM0800X	Durable Medical Equipment & Medical Supplies	DME suppliers who dispense oxygen accessories and concentrators.
207Q00000X	Pulmonology	Pulmonologists commonly prescribe and manage long-term oxygen therapy orders.
363L00000X	Home Health Services	Home health clinicians coordinate home oxygen equipment and replacements.
394000000X	Assistive Technology Services	Providers involved in fitting and advising on portable oxygen accessories.
207R00000X	Critical Care Medicine	Critical care physicians may document need for home oxygen in complex cases.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`J44.9`	Chronic obstructive pulmonary disease, unspecified	COPD is a common indication for long-term oxygen therapy and portable concentrator use; replacement DC adapter supports continued ambulatory oxygen use.
`J84.10`	Pulmonary fibrosis, unspecified	Interstitial lung disease with chronic hypoxemia may require portable oxygen concentrators and accessory replacements.
`I27.9`	Pulmonary heart disease, unspecified	Chronic pulmonary disease with cor pulmonale may necessitate LTOT and portable oxygen accessories.
`R09.02`	Hypoxemia	Direct clinical indication for oxygen therapy; supports medical necessity for replacement accessories.
`E66.9`	Obesity, unspecified	Obesity hypoventilation and related hypoxemia can be associated with need for supplemental oxygen during ambulation; accessory supports portability.
`J96.11`	Chronic respiratory failure with hypoxia	Explicit diagnosis that justifies ongoing oxygen equipment and accessories for ambulatory use.
`G47.33`	Obstructive sleep apnea (adult) (pediatric)	While primarily treated with PAP devices, comorbid nocturnal hypoxemia in some patients may indicate supplemental oxygen in portable form.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99211`	Office or other outpatient visit for the evaluation and management of an established patient, minimal problem	May be used when a brief office visit documents the need for replacement accessory and generates the DME order.
`99212`	Office or other outpatient visit for the evaluation and management of an established patient, straightforward medical decision making	Used when a clinician evaluates the patient’s oxygen needs and documents ongoing requirement for portable concentrator accessories.
`94640`	Pressurized or nonpressurized inhalation treatment for acute airway obstruction	Not directly related to billing the accessory but may be performed in the same clinical visit to assess respiratory status.
`94010`	Spirometry, including maximal voluntary ventilation, with bronchodilator when performed	Pulmonary function testing that may support the diagnosis and need for long-term oxygen therapy prior to DME dispensing.
`G0424`	Pulmonary rehabilitation, per diem (example of group code)	Rehabilitation services often coordinate with DME needs; included as a related outpatient service that may document functional benefit of portable oxygen use.

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