Airway Clearance Devices

This policy covers outpatient airway clearance devices—including oscillatory PEP devices, mechanical in‑exsufflation, and chest wall compression systems—for patients with impaired mucus clearance such as cystic fibrosis, chronic diffuse bronchiectasis, neuromuscular disease, and other hypersecretory lung disorders (with an Illinois-specific pediatric mandate for certain plans). Coverage requires documented need (e.g., CT-confirmed bronchiectasis), prior failure or inability to perform standard airway‑clearance therapies, active patient participation, and is subject to the member’s benefit plan; use for indications beyond CF/bronchiectasis is generally considered experimental and inpatient/postoperative use is excluded.

"Oscillatory positive expiratory pressure (PEP) devices are medically necessary for individuals with hypersecretory lung disease who produce excessive mucus, have difficulty clearing secretions, and..."