K0738 Portable Home Oxygen Compressor Reimbursement | OpenPayer

Summary & Overview

HCPCS K0738: Portable Home Oxygen Compressor Rental

HCPCS Level II code K0738 represents the rental of a portable gaseous oxygen system consisting of a home compressor used to fill portable oxygen cylinders and associated delivery components. The code covers an integrated package that includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing. This service supports patients who require ambulatory oxygen supplementation and in-home cylinder refilling capability.

Key national payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for home oxygen compressor rentals, payer coverage considerations, and typical sites of service. The publication outlines benchmarking metrics where available, common billing and coding considerations, and any recent policy updates that affect reimbursement and utilization for portable oxygen systems rented for home use.

This summary serves clinicians, billing professionals, and policy analysts seeking a national perspective on the classification, clinical application, and payer landscape for home-based portable oxygen compressor rentals billed with HCPCS Level II code K0738. Data not available in the input will be identified within the full content where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareK0738HCPCS Level IIhome oxygendurable medical equipmentportable oxygen compressoroxygen therapymedical billingrespiratory care

Billing Code Overview

HCPCS Level II code K0738 describes a portable gaseous oxygen system provided on a rental basis. The equipment is a home compressor used to fill portable oxygen cylinders and the bundled delivery includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing.

Service type: Durable medical equipment rental for home oxygen therapy, focused on furnishing a home-based compressor and associated portable oxygen containers and accessories.

Typical site of service: Patient's residence (home) for ongoing ambulatory oxygen needs and portable oxygen refilling while at home.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with chronic hypoxemic respiratory failure who requires a home oxygen delivery solution that combines a stationary home compressor with portable gaseous oxygen cylinders for ambulation. The patient has a prescription from a pulmonologist or primary care physician specifying a portable gaseous oxygen system and is evaluated in an outpatient durable medical equipment (DME) clinic or during a home health visit. The clinical workflow: the clinician documents the oxygen need with supporting objective data (pulse oximetry, arterial blood gas, or documented exertional desaturation), writes a signed order for oxygen equipment and rental of a home compressor used to fill portable cylinders, and the DME supplier verifies eligibility with the patient’s payor. The supplier delivers and sets up the home compressor, provides the portable cylinders, regulator, flowmeter, humidifier, nasal cannula or mask, and tubing, trains the patient and caregiver on equipment use and safety, and arranges ongoing monthly rental billing under K0738 until the equipment is no longer medically necessary or replaced. Typical site of service is the patient’s residence or a DME supplier location for delivery and setup.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when documentation shows substantially greater work or time for setup, unusual home environment, or extensive patient training beyond typical setup.

HCPCS K0195: Elevating Leg Rests for Wheelchair Base

HCPCS-K0861-POWER-WHEELCHAIR-GROUP-3-STANDARD-300LBS

HCPCS K0861: Power Wheelchair Group 3 Standard, 300 lb Capacity

HCPCS-K0609-AED-GARMENT-REPLACEMENT-ELECTRODES

HCPCS K0609: Replacement Electrodes for Garment-Type AEDs

HCPCS-K0836-POWER-WHEELCHAIR-GROUP-2-CAPTAINS-CHAIR-300-LB

HCPCS K0836: Power Wheelchair Group 2, Captain's Chair, 300 lb Capacity

HCPCS-K0815-POWER-WHEELCHAIR-GROUP1-SLING-SEAT-UP-TO-300LBS

HCPCS K0815: Power Wheelchair Group 1, Sling/Solid Seat, ≤300 lb

HCPCS-K0039-LEG-STRAP-H-STYLE

HCPCS K0039: Leg Strap, H Style

HCPCS-K0843-POWER-WHEELCHAIR-HEAVY-DUTY-301-450-LBS

HCPCS K0843: Power Wheelchair, Heavy Duty, 301–450 lb Capacity

HCPCS-K0891-POWER-WHEELCHAIR-GROUP-5-PEDIATRIC

HCPCS K0891: Power Wheelchair Group 5 Pediatric, Up to 125 lb

HCPCS-K0017-DETACHABLE-ADJUSTABLE-ARMREST-REPLACEMENT

HCPCS K0017: Detachable Adjustable-Height Armrest Base, Replacement

HCPCS-K0052-SWINGAWAY-DETACHABLE-FOOTRESTS-REPLACEMENT

HCPCS K0052: Swingaway Detachable Footrests, Replacement Only, Each

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Taxonomy Code	Specialty	Notes
`207Q00000X`	Pulmonology	Prescribing clinicians who assess and document chronic hypoxemia and oxygen requirements.
`207R00000X`	Internal Medicine	Primary care physicians frequently manage oxygen prescriptions and follow-up.
`261QM0800X`	Respiratory Therapy	Respiratory therapists provide equipment setup, education, and monitoring in home and outpatient settings.
`363L00000X`	Home Health Agency	Home health clinicians coordinate delivery, setup, and skilled assessment in the residence.
`3336C0005X`	Medical Equipment Supplier	DME supplier specialists responsible for delivery, maintenance, and billing of `K0738`

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`J44.9`	Chronic obstructive pulmonary disease, unspecified	Common cause of chronic hypoxemia requiring home oxygen and portable systems.
`J96.01`	Acute respiratory failure with hypoxia	May necessitate transition to home oxygen after stabilization and need for ambulatory oxygen support.
`J96.11`	Chronic respiratory failure with hypoxia	Direct indication for long-term supplemental oxygen and rental of home compressor with portable cylinders.
`I27.21`	Pulmonary hypertension due to respiratory disease	Associated hypoxemia may require continuous or ambulatory oxygen therapy.
`E11.9`	Type 2 diabetes mellitus without complications	Common comorbidity; not a direct indication but frequently present in patients receiving home oxygen.
`Z99.81`	Dependence on supplemental oxygen	Post-procedure or chronic status code documenting ongoing need for oxygen therapy at home.
`R09.02`	Hypoxemia	Symptom-level code supporting medical necessity for oxygen equipment.
`R06.02`	Shortness of breath	Symptom commonly documented in patients who are evaluated and prescribed ambulatory oxygen.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`94620`	Pulmonary stress testing; spirometry, including bronchodilator responsiveness when performed	Performed prior to or during evaluation to quantify airflow limitation and support oxygen need assessments.
`94729`	Carbon dioxide monitoring by pulse oximeter or transcutaneous monitoring, clinical staff time	Used for monitoring oxygenation and ventilation during assessment and home oxygen titration.
`94760`	Noninvasive ear or pulse oximetry for oxygen saturation; single determination	Provides objective oxygen saturation data to justify oxygen therapy and rental of equipment.
`94002`	Ventilation assist and management initiation, hospital inpatient, first day	In cases where the patient transitions from inpatient ventilatory support to home oxygen therapy, this code is part of the care continuum.
`99070`	Supplies and materials provided by physician over and above those usually included with the office visit	May be used when clinicians supply additional disposable oxygen accessories not included in the DME billing.

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