Suction Pumps - Policy Article

Suction pumps and related systems are reimbursable under the DME benefit when they meet reasonable and necessary criteria established in the related LCD and applicable statutory payment rules; specific HCPCS (e.g., E0600, E2000, A4605/A4624, K0743 with K0744–K0746) are covered when supported by appropriate diagnosis and documentation. Face-to-face encounters and Written Orders Prior to Delivery (Final Rule 1713) and PDAC coding verification for certain HCPCS (e.g., K0743) are required; disposable wound suction devices (A9270/A9272) and certain supplies (e.g., saline for tracheal lavage) are noncovered, and DME supplies provided in nursing facilities (POS 31/32) are denied.

"Portable or stationary home model respiratory suction pumps (HCPCS E0600) are covered under DME when reasonable and necessary per the related LCD and statutory payment requirements for oropharyngea..."