Mechanical In-exsufflation Devices - Policy Article

Mechanical in-exsufflation devices are covered under the DME benefit when the beneficiary meets the reasonable and necessary requirements in the related LCD and applicable statutory payment rules. Final Rule 1713 requires a face-to-face encounter and a Written Order Prior to Delivery (WOPD) for specified HCPCS codes (failure to obtain these prior to delivery results in denial), and HCPCS A7020 is reimbursable only as a replacement (not at initial issue) with the supporting diagnosis code on the claim.

"Mechanical in-exsufflation devices are covered under the Durable Medical Equipment (DME) benefit when the beneficiary meets the reasonable and necessary (R&N) requirements specified in the related ..."

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