Insurance Coding

Patients with chronic failure of natural airway clearance mechanisms can experience recurrent lung infections leading to pneumonia and permanent lung scarring, decreased pulmonary function, increased health care costs related to antibiotics and hospitalizations, loss of productivity, and, in some cases, morbidity and mortality.

Recognition of this potential downward health spiral has led federal, state and private payors to cover High Frequency Chest Wall Oscillation (HFCWO) for these patients. HFCWO now has an assigned HCPCS code.

High Frequency Chest Wall Oscillation has been approved by over 200 government payors and several hundred commercial payors. Coverage is not disease specific, but is based on evidence of retained secretions and problems with mucus mobilization. For additional information, please click on HFCWO and Airway Clearance above.

Neuromuscular Case for Reimbursement

When Electromed's reimbursement staff receives a referral for the SmartVest® Airway Clearance System, they will contact you to verify benefits and supply information required to attain a Prior Authorization. Included in the information will be details of the patient's medical status from our unique Certificate of Medical Necessity and Prescription (CMN/Rx) form. This "check-off" format with additional physician notes will allow your case managers, utilization review specialists and medical directors to very quickly assess the medical necessity for each referred patient. Our reimbursement staff works interactively with your department to provide the most appropriate service to you, the patients and their physicians.