Respiratory Assist Devices - Policy Article

Respiratory assist devices (E0470/E0471) and necessary accessories are covered under the DME benefit when all reasonable and necessary requirements in the related LCD and statutory/regulatory rules are met. Specified RAD items require a documented face-to-face encounter and a Written Order Prior to Delivery (Final Rule 1713), KX/GA/GZ modifiers must be applied appropriately with retained evidence or ABN, and monitoring devices billed under A9279 (and remote monitoring services) are statutorily non-covered.

"Respiratory assist devices (RADs) are covered under the Durable Medical Equipment benefit when reasonable and necessary requirements in the related Local Coverage Determination (LCD) and applicable..."

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