Anthem · Clinical Guideline · ANTHEM-CG-DME-34
Summary of the payer’s published policy. Not a coverage determination — confirm with Anthem before submitting.
Free account. Policy pages stay open to everyone.
Each code’s status is what the policy records for it. This page does not show the policy’s criteria. Read them in the payer’s source.
| Code | Code system | Status in this policy |
|---|---|---|
| E0950 | HCPCS | Covered |
| E0951 | HCPCS | Covered |
| E0952 | HCPCS | Covered |
| E0953 | HCPCS | Covered |
| E0954 | HCPCS | Covered |
| E0955 | HCPCS | Covered |
| E0956 | HCPCS | Covered |
| E0957 | HCPCS | Covered |
| E0958 | HCPCS | Covered |
| E0959 | HCPCS | Covered |
| E0960 | HCPCS | Covered |
| E0961 | HCPCS | Covered |
| E0966 | HCPCS | Covered |
| E0967 | HCPCS | Covered |
| E0968 | HCPCS | Covered |
| E0969 | HCPCS | Covered |
| E0970 | HCPCS | Covered |
| E0971 | HCPCS | Covered |
| E0973 | HCPCS | Covered |
| E0974 | HCPCS | Covered |
| E0978 | HCPCS | Covered |
| E0980 | HCPCS | Covered |
| E0981 | HCPCS | Covered |
| E0982 | HCPCS | Covered |
| E0983 | HCPCS | Covered |
| E0984 | HCPCS | Covered |
| E0985 | HCPCS | Covered |
| E0986 | HCPCS | Covered |
| E0988 | HCPCS | Covered |
| E0990 | HCPCS | Covered |
| E0992 | HCPCS | Covered |
| E0994 | HCPCS | Covered |
| E0995 | HCPCS | Covered |
| E1009 | HCPCS | Covered |
| E1010 | HCPCS | Covered |
| E1011 | HCPCS | Covered |
| E1014 | HCPCS | Covered |
| E1015 | HCPCS | Covered |
| E1016 | HCPCS | Covered |
| E1017 | HCPCS | Covered |
| E1018 | HCPCS | Covered |
| E1020 | HCPCS | Covered |
| E1022 | HCPCS | Covered |
| E1023 | HCPCS | Covered |
| E1028 | HCPCS | Covered |
| E1029 | HCPCS | Covered |
| E1030 | HCPCS | Covered |
| E1032 | HCPCS | Covered |
| E1033 | HCPCS | Covered |
| E1034 | HCPCS | Covered |
| E1225 | HCPCS | Covered |
| E1226 | HCPCS | Covered |
| E1227 | HCPCS | Covered |
| E1228 | HCPCS | Covered |
| E1296 | HCPCS | Covered |
| E1297 | HCPCS | Covered |
| E1298 | HCPCS | Covered |
| E2201 | HCPCS | Covered |
| E2202 | HCPCS | Covered |
| E2203 | HCPCS | Covered |
| E2204 | HCPCS | Covered |
| E2205 | HCPCS | Covered |
| E2206 | HCPCS | Covered |
| E2207 | HCPCS | Covered |
| E2208 | HCPCS | Covered |
| E2209 | HCPCS | Covered |
| E2210 | HCPCS | Covered |
| E2211 | HCPCS | Covered |
| E2212 | HCPCS | Covered |
| E2213 | HCPCS | Covered |
| E2214 | HCPCS | Covered |
| E2215 | HCPCS | Covered |
| E2216 | HCPCS | Covered |
| E2217 | HCPCS | Covered |
| E2218 | HCPCS | Covered |
| E2219 | HCPCS | Covered |
| E2220 | HCPCS | Covered |
| E2221 | HCPCS | Covered |
| E2222 | HCPCS | Covered |
| E2224 | HCPCS | Covered |
| E2225 | HCPCS | Covered |
| E2226 | HCPCS | Covered |
| E2227 | HCPCS | Covered |
| E2228 | HCPCS | Covered |
| E2230 | HCPCS | Covered |
| E2231 | HCPCS | Covered |
| E2291 | HCPCS | Covered |
| E2292 | HCPCS | Covered |
| E2293 | HCPCS | Covered |
| E2294 | HCPCS | Covered |
| E2295 | HCPCS | Covered |
| E2300 | HCPCS | Covered |
| E2301 | HCPCS | Covered |
| E2310 | HCPCS | Covered |
| E2311 | HCPCS | Covered |
| E2312 | HCPCS | Covered |
| E2313 | HCPCS | Covered |
| E2321 | HCPCS | Covered |
| E2322 | HCPCS | Covered |
| E2323 | HCPCS | Covered |
| E2324 | HCPCS | Covered |
| E2325 | HCPCS | Covered |
| E2326 | HCPCS | Covered |
| E2327 | HCPCS | Covered |
| E2328 | HCPCS | Covered |
| E2329 | HCPCS | Covered |
| E2330 | HCPCS | Covered |
| E2331 | HCPCS | Covered |
| E2340 | HCPCS | Covered |
| E2341 | HCPCS | Covered |
| E2342 | HCPCS | Covered |
| E2343 | HCPCS | Covered |
| E2351 | HCPCS | Covered |
| E2358 | HCPCS | Covered |
| E2359 | HCPCS | Covered |
| E2360 | HCPCS | Covered |
| E2361 | HCPCS | Covered |
| E2362 | HCPCS | Covered |
| E2363 | HCPCS | Covered |
| E2364 | HCPCS | Covered |
| E2365 | HCPCS | Covered |
| E2366 | HCPCS | Covered |
| E2367 | HCPCS | Covered |
| E2368 | HCPCS | Covered |
| E2369 | HCPCS | Covered |
| E2370 | HCPCS | Covered |
| E2371 | HCPCS | Covered |
| E2372 | HCPCS | Covered |
| E2373 | HCPCS | Covered |
| E2374 | HCPCS | Covered |
| E2375 | HCPCS | Covered |
| E2376 | HCPCS | Covered |
| E2377 | HCPCS | Covered |
| E2378 | HCPCS | Covered |
| E2381 | HCPCS | Covered |
| E2382 | HCPCS | Covered |
| E2383 | HCPCS | Covered |
| E2384 | HCPCS | Covered |
| E2385 | HCPCS | Covered |
| E2386 | HCPCS | Covered |
| E2387 | HCPCS | Covered |
| E2388 | HCPCS | Covered |
| E2389 | HCPCS | Covered |
| E2390 | HCPCS | Covered |
| E2391 | HCPCS | Covered |
| E2392 | HCPCS | Covered |
| E2394 | HCPCS | Covered |
| E2395 | HCPCS | Covered |
| E2396 | HCPCS | Covered |
| E2397 | HCPCS | Covered |
| E2398 | HCPCS | Covered |
| E2601 | HCPCS | Covered |
| E2602 | HCPCS | Covered |
| E2603 | HCPCS | Covered |
| E2604 | HCPCS | Covered |
| E2605 | HCPCS | Covered |
| E2606 | HCPCS | Covered |
| E2607 | HCPCS | Covered |
| E2608 | HCPCS | Covered |
| E2609 | HCPCS | Covered |
| E2610 | HCPCS | Covered |
| E2611 | HCPCS | Covered |
| E2612 | HCPCS | Covered |
| E2613 | HCPCS | Covered |
| E2614 | HCPCS | Covered |
| E2615 | HCPCS | Covered |
| E2616 | HCPCS | Covered |
| E2617 | HCPCS | Covered |
| E2619 | HCPCS | Covered |
| E2620 | HCPCS | Covered |
| E2621 | HCPCS | Covered |
| E2622 | HCPCS | Covered |
| E2623 | HCPCS | Covered |
| E2624 | HCPCS | Covered |
| E2625 | HCPCS | Covered |
| E2626 | HCPCS | Covered |
| E2627 | HCPCS | Covered |
| E2628 | HCPCS | Covered |
| E2629 | HCPCS | Covered |
| E2630 | HCPCS | Covered |
| E2631 | HCPCS | Covered |
| E2632 | HCPCS | Covered |
| E2633 | HCPCS | Covered |
| K0015 | HCPCS | Covered |
| K0017 | HCPCS | Covered |
| K0018 | HCPCS | Covered |
| K0019 | HCPCS | Covered |
| K0020 | HCPCS | Covered |
| K0037 | HCPCS | Covered |
| K0038 | HCPCS | Covered |
| K0039 | HCPCS | Covered |
| K0040 | HCPCS | Covered |
| K0041 | HCPCS | Covered |
| K0042 | HCPCS | Covered |
| K0043 | HCPCS | Covered |
| K0044 | HCPCS | Covered |
| K0045 | HCPCS | Covered |
| K0046 | HCPCS | Covered |
| K0047 | HCPCS | Covered |
| K0050 | HCPCS | Covered |
| K0051 | HCPCS | Covered |
| K0052 | HCPCS | Covered |
| K0053 | HCPCS | Covered |
| K0056 | HCPCS | Covered |
| K0065 | HCPCS | Covered |
| K0069 | HCPCS | Covered |
| K0070 | HCPCS | Covered |
| K0071 | HCPCS | Covered |
| K0072 | HCPCS | Covered |
| K0073 | HCPCS | Covered |
| K0077 | HCPCS | Covered |
| K0098 | HCPCS | Covered |
| K0105 | HCPCS | Covered |
| K0108 | HCPCS | Covered |
| K0195 | HCPCS | Covered |
| K0669 | HCPCS | Covered |
| K0733 | HCPCS | Covered |
| K0734 | HCPCS | Covered |
| K0735 | HCPCS | Covered |
| K0736 | HCPCS | Covered |
| K0737 | HCPCS | Covered |
| L3788 | HCPCS | Covered |