E0469, Lung expansion airway clearance, continuous high frequency oscillation, and
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Documentation Required
- Medical records documentation may be required to assess whether the member meets the clinical criteria for coverage.
Key Coverage Criteria
- High-frequency chest wall oscillation (HFCWO) system rental for 2 months is medically necessary for management of neuromuscular diseases, bronchiectasis, and cystic fibrosis when criteria are met.
- 2-month rental trial of a high-frequency chest wall oscillation (HFCWO) system is proven and medically necessary in the management of neuromuscular diseases, Bronchiectasis, and cystic fibrosis when criteria have been met.
- 2-month rental trial of a high-frequency chest wall oscillation (HFCWO) system is proven and medically necessary in the management of neuromuscular diseases, Bronchiectasis, and cystic fibrosis when criteria have been met.
4 Active Policies
ANTHEM-MP-A050283, Action
UHC-POL-airway-clearance-devices, Airway Clearance Devices
UMR-POL-UMR-airway-clearance-devices, Airway Clearance Devices
SUREST-POL-SUREST-airway-clearance-devices, Airway Clearance Devices
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