Airway Clearance Devices in the Ambulatory Setting - (0069)

Cigna covers PEP devices (E1399), mechanical insufflation‑exsufflation (E0482) and high‑frequency chest wall compression (E0483) in the ambulatory setting when indication‑specific clinical criteria are met, while intrapulmonary percussive ventilation for home use (E0481) and any use of MI‑E/HFCWC for nonlisted indications are considered not medically necessary. Coverage requires disease‑specific diagnostic confirmation (e.g., HRCT for bronchiectasis, listed ICD‑10 codes for MI‑E), documentation of failure/intolerance/contraindication to standard therapies where specified, proper coding/member benefit eligibility, and replacements only if malfunctioning/unrepairable/out of warranty or needed due to patient growth/change.

"Positive expiratory pressure devices (HCPCS E1399) are considered medically necessary for an individual with a diagnosis that is characterized by excessive mucus production and difficulty clearing ..."