RETIRED - Respiratory Assist Devices - Disease Classification


Content Provided on this page contains outdated information and instruction and should not be considered current. Noridian is providing this archived information for research purposes only. This archived article contains previously issued instructions that have since been updated or are no longer applicable for Medicare billing purposes.

Article retired due to content incorporation into the applicable Local Coverage Determination or related Policy Article.

Original Effective Date: 10/01/2002
Revision Effective Date: 11/01/2013

In the local medical review policy (LMRP) on Respiratory Assist Devices, the covered conditions are divided into four categories. The first category is Restrictive Thoracic Disorders. This category includes patients with either neuromuscular disorders (e.g., ALS) or severe chest wall deformities. It does not include patients with various interstitial lung diseases that often lead to pulmonary fibrosis and are sometimes referred to as restrictive lung diseases. RADs are not part of the treatment for these conditions. Similarly, obesity is not included in the Restrictive Thoracic Disorders category. Patients with severe obesity may qualify under other categories such as the Obstructive or Central Sleep Apnea categories if a polysomnogram and other tests, as detailed in the LMRP, indicate this is the appropriate diagnosis.

Suppliers should refer to the LMRP on Respiratory Assist Devices for further details concerning coverage, coding and documentation requirements for these devices.


Last Updated Dec 11 , 2023