Does E0481 require prior authorization?

Yes, E0481 requires prior authorization (high confidence). At least one active policy explicitly requires prior authorization.

`E0481`, Intrapulmonary percussive ventilation system and related accessories

HCPCS/CPT

Prior Auth Required

At least one active policy explicitly requires prior authorization (high confidence)

A Standard Written Order (SWO) must be communicated to the supplier before claim submission for items addressed in this policy.
For DMEPOS base items that require a Written Order Prior to Delivery (WOPD), the supplier must have received a signed WOPD before delivery; the WOPD must list the base item and may list separately billed associated options, accessories, and supplies.
Suppliers are required to maintain proof of delivery (POD) documentation in their files and must provide POD to the Medicare contractor upon request.

An item is covered only if it is in a defined Medicare benefit category, is reasonable and necessary for diagnosis/treatment or to improve function of a malformed body member, and meets all other applicable Medicare statutory and regulatory requirements.
High-frequency chest wall oscillation (HFCWO) system rental for 2 months is medically necessary for management of neuromuscular diseases, bronchiectasis, and cystic fibrosis when criteria are met.
Flutter / Acapella Device - ICD-10 codes covered if selection criteria are met : Q89.3 Quantitative Pupillometry/Pupillography
Home chest physiotherapy upon the initial prescription of chest physiotherapy to stabilize the member and to train family members or caregivers to administer chest physiotherapy.
Chest physiotherapy when the member’s pulmonary condition is unstable.
Airway oscillating devices (e.g., Flutter and Acapella) as medically necessary DME to assist in mobilizing respiratory tract secretions for members with: cystic fibrosis (CF), chronic bronchitis, bronchiectasis, immotile cilia syndrome (primary ciliary dyskinesia), and asthma.

ANTHEM-MP-A050283, Action

EVICORE-HPLAN-CIGNA-3C6BF790C032, Cigna Commercial DME Code List - Effective 03/07/2026

EVICORE-HPLAN-CIGNA-AFCE721BA4F3, Cigna Comprehensive Code List - Effective 03/07/2026

EVICORE-HPLAN-CIGNA_MEDICARE-268F28B96146, Cigna Medicare Advantage Durable Medical Equipment Code List - Effective 01/01/2025

L33786, Intrapulmonary Percussive Ventilation System

UHC-POL-airway-clearance-devices, Airway Clearance Devices

AETNA-CPB-0067, Chest Physiotherapy and Airway Clearance Devices

BCBSIL-DME101.027, Airway Clearance Devices

BCBSMT-DME101.027, Airway Clearance Devices

BCBSNM-DME101.027, Airway Clearance Devices

BCBSOK-DME101.027, Airway Clearance Devices

UMR-POL-UMR-airway-clearance-devices, Airway Clearance Devices

SUREST-POL-SUREST-airway-clearance-devices, Airway Clearance Devices

CIGNA-0069, Airway Clearance Devices in the Ambulatory Setting