Question 1

What is HCPCS code E0616?

Accepted Answer

HCPCS code E0616 is "Cardiac event recorder". Implantable cardiac event recorder with memory, activator and programmer

Question 2

What category is E0616 in?

Accepted Answer

E0616 belongs to HCPCS Category E (Durable Medical Equipment (DME)).

Question 3

When should I use HCPCS code E0616?

Accepted Answer

Use E0616 when billing for cardiac event recorder. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is E0616 covered by Medicare?

Accepted Answer

Coverage for E0616 (Cardiac event recorder) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for E0616?

Accepted Answer

Documentation for E0616 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).