Other Services
Chapter 8
Section 16.1
Mucus Clearance Devices
Issue Date: June
5, 1995
Revision: C-1,
March 10, 2017
1.0 HCPCS PROCEDURE
CODES
A7025, A7026, E0480 -
E0484, S8185
2.0 DESCRIPTION
2.1 Mucus clearance
devices are designed to clear mucus secretions from the lungs of
patients with mucociliary clearance impairment.
2.2 Some mucus clearance
devices resemble a combination of a smoker’s pipe and a referee’s whistle.
It consists of a hardened plastic mouthpiece at one end, a plastic
perforated cover at the opposite end, and a valve on the inside
created by a high-density stainless steel ball resting in a plastic circular
cone.
2.3 Other
bronchial drainage systems include an air oscillator and an inflatable
vest and uses high-frequency chest wall oscillations, which also
clear mucus from the airway wall. This type of system is a mechanical
form of Chest Physical Therapy (CPT) used as an alternative to conventional
CPT in patients with Cystic Fibrosis (CF).
3.0 POLICY
3.1 Mucus clearance
devices may be cost-shared for beneficiaries with mucus producing
lung diseases, including, but not limited to CF and Chronic Obstructive
Pulmonary Disease (COPD) (which encompasses both chronic bronchitis
and emphysema), and for beneficiaries with secretory impairment
that requires mucus clearance.
3.2 The mucus clearance device used must be
U.S. Food and Drug Administration (FDA) approved. Coverage can only
begin effective the date of FDA approval.
3.3 Intrapulmonary
Percussive Ventilation (IPV) (Healthcare Common Procedure Coding
System (HCPCS) code E0481) may be considered for cost-sharing when
the diagnosis is CF.
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