HFCWO and MIE Devices
High Frequency Chest Wall Oscillation (HFCWO) devices are covered for beneficiaries who meet criteria 1, 2, or 3 AND 4.
There is a diagnosis of cystic fibrosis (refer to the ICD-10 code list in the LCD-related Policy Article for applicable diagnoses). Critera 1
OR Critera 2
There is a diagnosis of bronchiectasis (refer to the “ ICD-10 code list in the LCD-related Policy Article for applicable diagnoses) which has been confirmed by a high resolution, spiral, or standard CT scan and which is characterized by:
Daily productive cough for at least 6 continuous months; OR
Frequent (i e , more than 2/year) exacerbations requiring antibiotic therapy
Chronic bronchitis and chronic obstructive pulmonary disease (COPD) in the absence of a confirmed diagnosis of bronchiectasis do not meet this criterion
OR Critera 3
The beneficiary has one of the following neuromuscular disease diagnoses (refer to the ICD-10 code list in the LCD-related Policy Article for applicable diagnoses):
Post-polio
Acid maltase deficiency
Anterior horn cell diseases
Multiple sclerosis Quadriplegia
Hereditary muscular dystrophy
Myotonic disorders
Other myopathies
Paralysis of the diaphragm
AND Critera 4
There must be well-documented failure of standard treatments to adequately mobilize retained secretions.
Mechanical in-exsufflation devices(E0482) are covered for beneficiaries who meet all of the following criteria;
Critera 1
They have a neuromuscular disease (refer to the ICD-10 code list in the LCD-related Policy Article for applicable diagnoses)
Critera 2
This condition is causing a significant impairment of chest wall OR/AND diaphragmatic movement, such that it results in an inability to clear retained secretions
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