Airway Clearance Devices - DME.O2.101.A

Evicore covers HFCWO (E0483/A7025/A7026) and oscillatory PEP devices (E0480/E0484/S8185) for patients with excessive mucus and impaired secretion clearance who have neuromuscular cough impairment, cystic fibrosis, or imaging‑confirmed bronchiectasis with chronic cough or frequent antibiotics (COPD is also an indication for oscillatory PEP), and it covers mechanical insufflation‑exsufflation (E0482) only for neuromuscular cough impairment; intrapulmonary percussive ventilation (E0481) is investigational and not covered. Key requirements are documentation of excessive mucus/difficulty clearing secretions, imaging confirmation of bronchiectasis (preferably noncontrast chest CT) and evidence of chronic cough or frequent antibiotics where applicable, plus a prior trial or intolerance of conventional chest therapies before HFCWO or oscillatory PEP.

" "The individual has bronchiectasis (a permanent enlargement of some of the airways in the lungs that makes it hard to move fluid out of the lungs) confirmed on imaging and any of the following:" ..."