Airway Clearance Devices – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare covers a two-month rental trial of high-frequency chest wall oscillation (HFCWO) systems as medically necessary for neuromuscular diseases, bronchiectasis, and cystic fibrosis when diagnosis codes and clinical criteria are met; HFCWO for other conditions and combination CPEP/CHFO/OLE devices and home intrapulmonary percussive ventilation (IPV) are considered unproven and not medically necessary. Coverage requires medical-record documentation (including CT confirmation/classification for bronchiectasis when applicable), demonstration during the initial two-month trial of tolerance and clinical benefit, and ongoing medical necessity per InterQual criteria and member-specific plan terms.

"G35."

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