E0481 — Intrapulmonary percussive ventilation system and related accessories
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Documentation Required
- A Standard Written Order (SWO) must be communicated to the supplier before claim submission for items addressed in this policy.
- For DMEPOS base items that require a Written Order Prior to Delivery (WOPD), the supplier must have received a signed WOPD before delivery; the WOPD must list the base item and may list separately billed associated options, accessories, and supplies.
- Suppliers are required to maintain proof of delivery (POD) documentation in their files and must provide POD to the Medicare contractor upon request.
- Claims must be correctly coded according to CMS HCPCS guidelines, LCDs, LCD-related Policy Articles, and DME MAC articles; inadequate coding documentation may result in denial.
Key Coverage Criteria
- An item is covered only if it is in a defined Medicare benefit category, is reasonable and necessary for diagnosis/treatment or to improve function of a malformed body member, and meets all other applicable Medicare statutory and regulatory requirements.
- G35.D Multiple sclerosis, unspecified
- G71.00 Muscular dystrophy, unspecified
- Z99.11 Dependence on respirator [ventilator] status
- G12.22 Progressive bulbar palsy
- G12.25 Progressive spinal muscle atrophy
7 Active Policies
L33786 — Intrapulmonary Percussive Ventilation System
J19
UHC-POL-airway-clearance-devices — Airway Clearance Devices
AETNA-CPB-0067 — Chest Physiotherapy and Airway Clearance Devices
CIGNA-0069 — Airway Clearance Devices in the Ambulatory Setting - (0069)
UMR-POL-UMR-airway-clearance-devices — Airway Clearance Devices
Related Codes
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