HCPCS Code E0667: Segmental pneumatic appliance, full leg

Key Takeaways

HCPCS Code E0667 is the segmental pneumatic appliance (full leg) code billed separately from pneumatic compressor codes E0650, E0651, and E0652

Medicare coverage requires a qualifying diagnosis — lymphedema or a venous stasis ulcer from chronic venous insufficiency — plus a documented failed trial of conservative therapy, under NCD 280.6

Common billing error: billing the appliance without the paired compressor code, or using E0667 (full leg) when E0669 (half leg) is the correct appliance for a below-knee-only order

Practice management software like Pabau helps DME practices keep organized clinical documentation that supports medical necessity and reduces claim denials

HCPCS Code E0667 is a segmental pneumatic appliance for use with a pneumatic compressor, full leg, billed separately from the compressor itself under E0651 or E0652. Most denials trace back to one of three mistakes: submitting the appliance code without the compressor, selecting the wrong appliance code for the body region, or sending incomplete medical necessity documentation.

Medicare’s National Coverage Determination NCD 280.6 governs all three of these requirements. According to CMS, HCPCS Level II codes like E0667 are maintained annually and follow DMEPOS billing rules that differ from standard procedure code submissions. This guide covers the clinical indications, fee schedule, documentation checklist, correct code pairing, and common errors for HCPCS Code E0667.

HCPCS Code E0667: definition and code details

HCPCS Code E0667 describes a segmental pneumatic appliance for use with a pneumatic compressor, full leg. It falls within the DMEPOS billing category under HCPCS Level II, the Healthcare Common Procedure Coding System classification maintained by CMS for durable medical equipment, prosthetics, orthotics, and supplies.

The code was added to the code set on January 1, 1985, took its current effective date of January 1, 1996, and remains valid for 2026.

The key distinction: E0667 covers the appliance that wraps the full leg, not the compressor unit that powers it. These two pieces of equipment are billed under separate HCPCS codes and must not be bundled into a single line item.

Clinical indications and NCD 280.6 coverage criteria

Medicare coverage for HCPCS Code E0667 is governed by National Coverage Determination NCD 280.6 (Medicare NCD Manual, Pub. 100-03, Ch. 1, section 280.6), which outlines the diagnoses and clinical conditions that support medical necessity for pneumatic compression devices.

The DME MACs retired the prior Local Coverage Determination LCD L33829 and its Policy Article A52488 for dates of service on or after November 14, 2024.

Billing without a qualifying diagnosis is the fastest path to denial. Clinicians ordering pneumatic compression therapy for the full leg should confirm the patient’s diagnosis meets NCD 280.6’s criteria before submitting a claim.

Medicare covers pneumatic compression devices, including E0667, for only two qualifying conditions under NCD 280.6:

• Lymphedema of the lower extremity (primary or secondary), after a four-week trial of conservative therapy — compression bandaging or garments, exercise, and limb elevation — has failed
• Chronic venous insufficiency of the lower extremity with a venous stasis ulcer, after a six-month trial of conservative therapy has failed

Coverage also requires a face-to-face physician evaluation and documentation of the clinical rationale, on top of the conservative-therapy trial above. Confirm current NCD 280.6 requirements with your DME MAC, since CMS updates coverage guidance periodically.

Practice management software like Pabau helps DME practices keep the face-to-face evaluation notes, conservative-therapy trial records, and physician rationale organized in one place, ready for when the claim is prepared.

ICD-10 diagnosis codes commonly paired with E0667

Every E0667 claim needs a supporting ICD-10 diagnosis code that matches one of the two conditions NCD 280.6 recognizes as medically necessary. The table below covers the most frequently paired codes; a nonspecific code such as I87.9 doesn’t establish medical necessity on its own.

Always verify accepted diagnosis codes against the current NCD 280.6 and your DME MAC’s coverage article before billing.

Selecting an overly general ICD-10 code when a more specific code exists is a common audit trigger. I89.0 is preferred over broader circulatory codes when the underlying condition is clearly lymphedema. When a venous stasis ulcer is present, pair the diagnosis with the appropriate wound care code, such as 97597, rather than relying on the compression appliance code alone.

E0667 Medicare fee schedule and reimbursement rates (2026)

Medicare reimbursement for HCPCS Code E0667 is set through the DMEPOS fee schedule and varies by CMS geographic payment locality. Rates are updated annually. The table below shows representative national average figures; actual allowed amounts depend on the beneficiary’s location and whether the supplier is participating or non-participating.

For the most current allowed amounts by locality, use the AAPC HCPCS code lookup or pull the 2026 DMEPOS fee schedule directly from CMS. Rates in competitive bidding areas may differ significantly from the national fee schedule.

Documentation requirements for HCPCS Code E0667 claims

Incomplete documentation is the top reason E0667 claims are denied or recouped on audit. CGS Medicare guidance and NCD 280.6 together define what the clinical record must contain before the appliance is dispensed.

A well-maintained digital record created at the point of care is far harder to challenge than retrospective documentation. Structured intake forms apply the same principle: capture the right information at the right time.

• Written physician order: signed and dated, specifying the pneumatic compression appliance for the full leg
• Face-to-face evaluation: documented encounter showing the ordering physician assessed the patient in person
• Diagnosis confirmation: clinical notes confirming a qualifying ICD-10 diagnosis (e.g. lymphedema I89.0)
• Failure of conservative therapy: documentation that elevation, compression stockings, or other conservative measures were tried for the NCD-required period (four weeks for lymphedema, six months for a venous stasis ulcer) and proved insufficient
• Standard Written Order (SWO): replaced the Detailed Written Order effective January 1, 2020 (CMS-1713); communicated to the supplier and signed by the treating practitioner before billing
• Proof of delivery: patient signature confirming receipt of the E0667 appliance
• Certificate of Medical Necessity (CMN): eliminated for all DMEPOS claims with dates of service on or after January 1, 2023 — claims that include one are rejected; do not submit

Retain all documentation for at least seven years. Medicare audit contractors can request records well after the claim date, and missing records are treated as if the service never occurred.

Correct code pairing: E0667 with pneumatic compressor codes

The single most-cited coding error in Noridian Medicare’s DME MAC guidance is submitting the appliance code without a paired compressor code. HCPCS Code E0667 is the appliance; the compressor is a separate piece of equipment billed under a separate code.

Both must appear on the claim, matched correctly to what was actually dispensed. E0570 illustrates the same appliance-plus-compressor pairing requirement for a different piece of DME.

Bill E0667 with E0651 or E0652 depending on the compressor’s specifications. Pairing E0667 with the non-segmental compressor E0650 is incorrect and will trigger a denial or audit finding. Always match the appliance code to the actual compressor dispensed, not the most commonly ordered unit.

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E0667 vs. E0669 and related appliance codes

The E0655-E0677 range covers both segmental and non-segmental pneumatic appliances for different body regions and limb segments. Selecting the wrong appliance code is a frequent claim error, particularly between E0667 (full leg) and its true half-leg counterpart, E0669 (half leg). The distinction hinges entirely on whether the appliance covers the entire lower extremity or only the below-knee segment.

E0668 is easy to confuse with E0669 by code proximity, but it describes a different body region: the segmental full-arm appliance, not a half-leg option. E0673 follows the same body-region logic within the same code family.

The clinically meaningful comparison is E0667 against E0669: both are segmental leg appliances, and the only difference is whether the physician’s order covers the full leg or stops at the knee.

E0668 sits in the same numeric range but describes a different body region, the segmental full-arm appliance, so it should never be substituted for either leg code. Confirm the treated limb and its full extent against the physician’s order before selecting between E0667 and E0669.

Applicable billing modifiers

DMEPOS claims for HCPCS Code E0667 may require specific modifiers depending on the rental or purchase method, supplier type, and bilateral dispensing. Common modifiers include:

• RR (rental): indicates the item is being rented to the beneficiary
• NU (new equipment): indicates the item is being purchased new
• KX: confirms that documentation in the beneficiary’s medical record supports the medical necessity criteria in NCD 280.6
• LT / RT: left or right side, if bilateral appliances are being billed on separate claim lines

The KX modifier is particularly important: submitting E0667 without KX when NCD 280.6 requires it will result in automatic denial. Verify modifier requirements with your specific DME MAC before billing. Practice management software helps track modifier requirements alongside documentation.

Common billing errors to avoid

• Billing E0667 without a paired compressor code (E0651 or E0652): the appliance code alone is incomplete and will deny
• Using E0660 instead of E0667: E0660 is non-segmental; E0667 is segmental; the physician order must specify which type was prescribed
• Using E0667 when E0669 is correct: if the physician’s order and documentation support only a below-knee appliance, E0669 (half leg) is the correct code, not the full-leg E0667. Do not confuse either with E0668, which is a segmental full-arm appliance for a different body region
• Missing the KX modifier: required when NCD 280.6 criteria are met and documented
• Submitting before delivery: DMEPOS claims must reflect actual delivery; billing before the item reaches the patient is a compliance violation
• Inadequate medical necessity documentation: a diagnosis code alone is insufficient; the clinical notes must support why pneumatic compression was medically necessary

How practice management software simplifies E0667 billing

The disconnect between the clinical record and the billing system causes most E0667 denials. When a physician orders pneumatic compression therapy, the documentation in the chart needs to flow directly into the claim without transcription errors.

Manual hand-offs between clinical notes and billing entries introduce exactly the kind of errors that NCD 280.6 audits expose. Digital intake forms close that disconnect by capturing structured data at the point of care.

Pabau connects clinical documentation to billing workflows, so the information required for E0667 medical necessity is captured in the correct fields from the outset — unlike generic medical billing software that keeps clinical and billing data in separate systems.

Practices using physical therapy EMR or wellness clinic software integrated with billing report fewer claim rejections because clinical notes and claim data share a single source of truth.

For DME providers billing HCPCS Code E0667 regularly, an integrated system reduces the back-and-forth of chasing missing documentation before a claim can be submitted. For more on how integrated billing and documentation work together, see our guide to EHR integration.

Conclusion

HCPCS Code E0667 claims fail most often because of a missing compressor code, the wrong appliance code for the body region, or documentation that does not satisfy NCD 280.6. Getting all three right requires that clinical orders, diagnosis coding, and DMEPOS billing rules stay connected throughout the workflow.

Pabau brings clinical documentation and billing information together, so the record supports the claim without manual reconciliation. To see how this applies to your DME billing setup, book a demo and we’ll walk through the E0667 documentation workflow for your practice.

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