E1620 Blood Pump Hemodialysis Reimbursement | OpenPayer

Summary & Overview

HCPCS E1620: Blood Pump for Hemodialysis, Replacement

HCPCS Level II code E1620 represents a replacement blood pump used during hemodialysis. This durable medical equipment item is critical to the safe and effective delivery of dialysis therapy and has national relevance because consistent access to functioning dialysis equipment affects patient safety, treatment continuity, and facility operations. Common payers for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise overview of what E1620 covers, how it is used in clinical practice, and the typical sites of service where replacements occur. The publication includes payer coverage context, common modifiers in use, and benchmarking where available. Policy and billing considerations relevant to durable medical equipment in dialysis settings are summarized to inform coding, claims submission, and coverage conversations at a national level.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareE1620HCPCS Level IIhemodialysisblood pumpdurable medical equipmentdialysis equipmentoutpatient dialysismedical device replacementbilling code

Billing Code Overview

HCPCS Level II code E1620 describes a blood pump for hemodialysis, replacement. This item is a component used in hemodialysis procedures to circulate blood through the dialysis circuit and machine. The service type is medical device replacement for hemodialysis treatment. The typical site of service is an outpatient dialysis center or hospital outpatient department where maintenance or replacement of dialysis equipment occurs.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with end-stage renal disease (ESRD) receiving maintenance hemodialysis in an outpatient dialysis center or inpatient hospital setting. During a routine dialysis session the dialysis machine alarm indicates loss of appropriate blood flow due to a malfunctioning or thrombotic blood pump. Nursing staff removes the defective blood pump assembly and replaces it with a new, compatible blood pump component (E1620) to restore adequate extracorporeal circulation. The workflow includes verification of device compatibility, documentation of pump serial/lot number, temporary interruption of dialysis, clamping and disconnecting blood lines per infection control protocol, installation of the replacement blood pump, priming and reestablishing blood flow, monitoring for differential pressures and air detection, and documenting the clinical reason for replacement (device failure, clotting, or routine manufacturer-recommended replacement). Typical sites of service are outpatient dialysis centers (hospital-affiliated or free-standing) and inpatient acute care units providing hemodialysis. Common clinical reasons for pump replacement include device malfunction, unexpected alarm conditions, visible mechanical damage, or contamination risk during a dialysis session.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier	Use when no modifier applies; standard reporting.

HCPCS Level II E1239: Power Wheelchair, Pediatric Size

HCPCS-E0493-ORAL-NEUROMUSCULAR-TONGUE-STIMULATION-DEVICE-90-DAY

HCPCS E0493: Oral Neuromuscular Electrical Stimulation Device, Tongue

HCPCS-E0457-CHEST-SHELL-CUIRASS-DME

HCPCS E0457: Chest Shell (Cuirass) for External Thoracic Support

HCPCS-E1140-DETACHABLE-ARMS-SWING-AWAY-FOOTRESTS-WHEELCHAIR

HCPCS Level II E1140: Wheelchair with Detachable Arms and Swing-Away Footrests

HCPCS-E2506-SPEECH-GENERATING-DEVICE-DIGITIZED-40MIN-PLUS

HCPCS E2506: Speech Generating Device, Digitized Speech >40 Minutes

HCPCS-E0188-SYNTHETIC-SHEEPSKIN-PAD

HCPCS E0188: Synthetic Sheepskin Pad for Pressure Relief

HCPCS-E0953-WHEELCHAIR-LATERAL-THIGH-KNEE-SUPPORT

HCPCS E0953: Wheelchair Lateral Thigh or Knee Support

HCPCS-E2104-HOME-BLOOD-GLUCOSE-MONITOR-INTEGRATED-CARTRIDGE

HCPCS E2104: Home Blood Glucose Monitor with Integrated Lancing/Test Cartridge

HCPCS-E0747-OSTEOGENESIS-STIMULATOR-ELECTRICAL-NON-INVASIVE

HCPCS E0747: Osteogenesis Stimulator, Electrical, Non-Invasive, Non-Spinal

HCPCS-E1004-POWER-SEATING-RECLINE-MECHANICAL-SHEAR-REDUCTION

HCPCS E1004: Power Seating Recline with Mechanical Shear Reduction

Showing 1–10 of 670

Taxonomy Code	Specialty	Notes
`2080P0207X`	Nephrology	Nephrologists oversee dialysis prescription and clinical decisions regarding pump replacement.
`175H00000X`	Dialysis Facility	Facility taxonomy for outpatient dialysis centers performing the supply exchange.
`174400000X`	Hospitalist/Internal Medicine	Hospital-based physicians who manage inpatient dialysis and order replacements.
`163WC0000X`	Registered Nurse	Nurses perform the hands-on replacement and monitoring; nursing taxonomy represents provider role.
`2086S0102X`	Vascular Surgeon	Vascular surgeons may be involved if pump replacement occurs during vascular access procedures or complications.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N18.6`	End stage renal disease	Primary indication for maintenance hemodialysis and frequent need for extracorporeal circuit components such as blood pumps.
`N18.5`	Chronic kidney disease, stage 5	Advanced CKD patients may require hemodialysis and replacement of dialysis machine components when malfunction occurs.
`T82.7XXA`	Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts, initial encounter	Used when device-related infection or inflammatory reaction affects vascular access or extracorporeal circuit necessitating component replacement.
`I97.89`	Other postprocedural complications and disorders of the circulatory system	Can apply when postprocedural complications (e.g., thrombosis, device malfunction) lead to pump replacement.
`T82.4XXA`	Mechanical complication of vascular device, initial encounter	Applicable when mechanical failure of extracorporeal circuit components or vascular devices prompts replacement of a blood pump.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90935`	Hemodialysis procedure with single evaluation by a physician or other qualified health care professional; for initiation of dialysis	Performed when initiating or troubleshooting dialysis sessions; may precede or follow pump replacement if clinical evaluation is required.
`90937`	Hemodialysis procedure with repeated evaluation(s) by a physician or other qualified health care professional	Used for ongoing dialysis sessions requiring repeated physician evaluation around the time of pump replacement.
`90999`	Unlisted dialysis procedure, inpatient or outpatient	Used when a specific dialysis-related service does not have an assigned CPT code, potentially for complex device exchanges or atypical situations associated with pump replacement.
`36831`	Vascular access maintenance, thrombectomy of dialysis access (percutaneous)	Performed when clotting of the extracorporeal circuit or vascular access contributes to pump failure and interventional treatment is needed.
`36556`	Insertion of non-tunneled hemodialysis catheter, without subcutaneous port or pump	Performed when catheter malfunction requires replacement of access rather than only the blood pump; may be performed after unsuccessful pump troubleshooting.

OpenPayer