About this policy
CMS National Coverage Determination | ncd_id=229 | manual_section=240.5 | coverage_level_code=3 | national_coverage_type=True | under_review=False | lab_ncd=False
Coverage indications
Studies do not demonstrate any advantage of IPV over that achieved with good pulmonary care in the hospital environment and there are no studies in the home setting. There are no data to support the effectiveness of the device. Therefore, IPV in the home setting is not covered.
Documentation requirements
Item/Service Description: IPV is a mechanized form of chest physical therapy. Instead of a therapist clapping or slapping the patient's chest wall, the IPV delivers mini-bursts (more than 200 per minute) of respiratory gasses to the lungs via a mouthpiece. Its intended purpose is to mobilize endobronchial secretions and diffuse patchy atelectasis. The patient controls variables such as inspiratory time, peak pressure and delivery rates. Revision History: 05/1997 - Changed effective date of TN 95 to 07/14/1997. Effective date 07/14/1997. (TN 100) 04/1997 - Provided that home use is not covered. Effective date 05/14/1997. (TN 95) Benefit Categories: 23 - Durable Medical Equipment Transmittal: transmittal_number=100 | transmittal_issue_date=1997-05-01
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
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