Inhaled Nitric Oxide

Inhaled nitric oxide (iNO) therapy and diagnostic assessment of pulmonary vasoreactivity are covered for treating hypoxic respiratory failure. Coverage is limited to term and near‑term neonates (≥34 weeks gestation) with clinical or echocardiographic evidence of pulmonary hypertension used with ventilatory support and other appropriate agents; use in preterm infants (<34 weeks), older children, adults, postoperative or post‑transplant settings, and most other indications is considered experimental/investigational or not FDA‑approved (some COVID‑19 use was only emergency expanded access), and iNO should be discontinued if ECMO is initiated.

"Therapeutic use as component of treatment for hypoxic respiratory failure in neonates born at ≥34 weeks 0 days gestation."

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