CG-DME-54 Mechanical Insufflation-Exsufflation Devices

This policy addresses mechanical insufflation-exsufflation (MI-E) cough-assist devices (HCPCS E0482) used to mobilize and clear respiratory secretions. They are medically necessary when the patient is unable to cough or clear secretions due to a chronic neuromuscular disorder or respiratory muscle weakness (e.g., ALS, SMA, muscular dystrophy, MS, poliomyelitis, spinal cord injury) and other cough augmentation methods (e.g., chest physiotherapy, bagging, “frog” breathing, breath stacking) have failed or are documented as unlikely to be adequate. MI-E devices are not medically necessary when these criteria are not met or for other indications, including chronic obstructive pulmonary disease.

"Use of a mechanical insufflation-exsufflation device (see Discussion/General Information section below for examples) is consideredmedically necessarywhenallof the following are met:"