Before an item can be considered DME, it must meet all of the following requirements:

• It must be able to withstand repeated use.
• It must be primarily and customarily used to serve a medical purpose.
• It must be generally not useful to a person in the absence of an illness or injury.
• It must be appropriate for use in the home.

All E codes fall under the jurisdiction of the DME MAC unless otherwise noted.

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• E1160

  Wheelchair, fixed full length arms, swing away detachable elevating legrests

• E1161

  Manual adult size wheelchair, includes tilt in space

• E1170

  Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests

• E1171

  Amputee wheelchair, fixed full length arms, without footrests or legrest

• E1172

  Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest

• E1180

  Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests

• E1190

  Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests

• E1195

  Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests

• E1200

  Amputee wheelchair, fixed full length arms, swing away detachable footrest

• E1220

  Wheelchair; specially sized or constructed, (indicate brand name, model number, if any) and justification

• E1221

  Wheelchair with fixed arm, footrests

• E1222

  Wheelchair with fixed arm, elevating legrests

• E1223

  Wheelchair with detachable arms, footrests

• E1224

  Wheelchair with detachable arms, elevating legrests

• E1225

  Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each

• E1226

  Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each

• E1227

  Special height arms for wheelchair

• E1228

  Special back height for wheelchair

• E1229

  Wheelchair, pediatric size, not otherwise specified

• E1230

  Power operated vehicle (three or four wheel nonhighway) specify brand name and model number

• E1231

  Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system

• E1232

  Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system

• E1233

  Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system

• E1234

  Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system

• E1235

  Wheelchair, pediatric size, rigid, adjustable, with seating system

• E1236

  Wheelchair, pediatric size, folding, adjustable, with seating system

• E1237

  Wheelchair, pediatric size, rigid, adjustable, without seating system

• E1238

  Wheelchair, pediatric size, folding, adjustable, without seating system

• E1239

  Power wheelchair, pediatric size, not otherwise specified

• E1240

  Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest

• E1250

  Lightweight wheelchair, fixed full length arms, swing away detachable footrest

• E1260

  Lightweight wheelchair, detachable arms (desk or full length) swing away detachable footrest

• E1270

  Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests

• E1280

  Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests

• E1285

  Heavy duty wheelchair, fixed full length arms, swing away detachable footrest

• E1290

  Heavy duty wheelchair, detachable arms (desk or full length) swing away detachable footrest

• E1295

  Heavy duty wheelchair, fixed full length arms, elevating legrest

• E1296

  Special wheelchair seat height from floor

• E1297

  Special wheelchair seat depth, by upholstery

• E1298

  Special wheelchair seat depth and/or width, by construction

• E1300

  Whirlpool, portable (overtub type)

• E1301

  Whirlpool tub, walk-in, portable

• E1310

  Whirlpool, non-portable (built-in type)

• E1352

  Oxygen accessory, flow regulator capable of positive inspiratory pressure

• E1353

  Regulator

• E1354

  Oxygen accessory, wheeled cart for portable cylinder or portable concentrator, any type, replacement only, each

• E1355

  Stand/rack

• E1356

  Oxygen accessory, battery pack/cartridge for portable concentrator, any type, replacement only, each

• E1357

  Oxygen accessory, battery charger for portable concentrator, any type, replacement only, each

• E1358

  Oxygen accessory, dc power adapter for portable concentrator, any type, replacement only, each

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HCPCS Level II codes and descriptors are approved and maintained jointly by the alpha-numeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). — Updated 6/3/2026

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