![]() ![]() Lung transplant recipients, within the first 6 months post-operatively, who are unable to tolerate standard chest physiotherapy. Quadriplegia regardless of underlying etiology.Anterior horn cell diseases, including amyotrophic lateral sclerosis or.The member has one of the following neuromuscular disease diagnoses:.Cystic fibrosis or immotile cilia syndrome.Bronchiectasis, confirmed by CT scan, characterized by daily productive cough for at least 6 continuous months or by frequent (i.e., more than 2 times/year) exacerbations requiring antibiotic therapy.Positive expiratory pressure (PEP) mask for CF, chronic bronchitis, immotile cilia syndrome, asthma, and chronic obstructive pulmonary disease (COPD) Īetna considers high-frequency chest compression systems (e.g., the AffloVest, the Frequencer, the Monarch Airway Clearance System, the SmartVest, the MedPulse Respiratory Vest System, the Vest Airway Clearance System, the ABI Vest, Respin11 Bronchial Clearance System, and the InCourage Vest/System) medically necessary DME in lieu of chest physiotherapy for the following indications, where there is a well documented failure of standard treatments to adequately mobilize retained secretions:.Mechanical percussors (e.g., Fluid Flo, Frequencer, and VibraLung Acoustical Percussor) for CF, chronic bronchitis, bronchiectasis, immotile cilia syndrome, and asthma.Airway oscillating devices (e.g., Flutter and Acapella) for cystic fibrosis (CF), chronic bronchitis, bronchiectasis, immotile cilia syndrome (also known as primary ciliary dyskinesia) and asthma.Note: Chest physiotherapy by a respiratory therapist is not considered medically necessary for persons whose pulmonary condition is stable, as chest physiotherapy can be competently administered at home by a family member or caregiver.Īetna considers the following airway clearance devices medically necessary durable medical equipment (DME) to assist in mobilizing respiratory tract secretions for members with the conditions that are indicated below: Chest physiotherapy when the member’s pulmonary condition is unstable.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.This Clinical Policy Bulletin addresses chest physiotherapy and airway clearance devices.Īetna considers the folowing interventions by a respiratory therapist medically necessary: On the front of the device is a setting that controls the amount of PEP set it at the highest level that you can tolerate and still be about to do 3 sets of 10 breaths.(Replaces CPBs 252, 280, 333) Table Of Contents Policy Applicable CPT / HCPCS / ICD-10 Codes Background References Since this is a Positive End Pressure device exhaling through it actively means that you are exercising your diaphragm a little with each exhalation. Do multiple treatments daily any time you are having problems with secretions. Between each set forcibly cough once or twice. Exhale just a bit more actively with each set and on the last set exhale increasingly forcibly on the last four breaths. You should hear and feel the device flutter. Take a deeper than normal breath and exhale through the device actively. Doing it correctly requires a little effort and concentration. Effectiveness seems to be directly related to how well the treatment is done as well as the need for it. Since I listen to patients lung sounds before and after the treatment, I can tell you with certainty that the Aerobika helps move secretions and opens the airways, sometimes very dramatically. I have used all three devices with patients the Flutter, The Acapella and the Aerobika. I am a RRT who works in an acute care setting. ![]()
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