Respiratory Assist Devices - JD DME
Respiratory Assist Devices
Coverage
- Respiratory Assist Devices Local Coverage Determination (LCD)
- Respiratory Assist Devices Policy Article
Documentation
- Standard Documentation Requirements for All Claims Submitted to DME MACs
- Clinician Checklist Central Sleep Apnea or Complex Sleep Apnea [PDF] - Checklist to assist clinicians with coverage and documentation requirements
- Clinician Checklist Continued RAD Therapy [PDF] - Checklist to assist clinicians with coverage and documentation requirements
- Clinician Checklist Hypoventilation Syndrome - Respiratory Assist Devices (RADs) - With or Without Backup Feature [PDF] - Checklist to assist clinicians with coverage and documentation requirements
- Clinician Checklist Respiratory Assist Device (RAD) - Restrictive Thoracic Disorder [PDF] - Checklist to assist clinicians with coverage and documentation requirements
- Clinician Checklist for Respiratory Assist Devices (RAD) - Severe COPD [PDF] - Checklist to assist clinicians with coverage and documentation requirements
- Clinician Checklist for Ventilators [PDF] – Checklist to assist clinicians with coverage and documentation requirements
- Clinician Letter - Medical Records [PDF] - Letter may be sent to clinicians to assist in obtaining documentation
- Clinician Letter - RAD for Central Sleep Apnea or Complex Sleep Apnea [PDF]
- Clinician Letter - RAD for Chronic Obstructive Pulmonary Disease (COPD) [PDF]
- Clinician Letter - RAD for Hypoventilation Syndrome [PDF]
- Clinician Letter - RAD for Restrictive Thoracic Disorders [PDF]
- RAD Documentation Checklist [PDF] - Checklist to ensure suppliers gather all required documentation
Reviews/Audits
- Medical Review - View notifications/findings of pre/post claim reviews completed by Noridian Medical Review
Tips
Topic | Details |
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Multi-function ventilator (HCPCS code E0467) |
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RAD vs. PAP Compliance |
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Diagnosis Categories |
A RAD (E0470, E0471) is covered for those beneficiaries with one of the following clinical disorders:
RAD is a diagnosis driven policy each with their own coverage criteria requirements outlined in the LCD. |
Replacement |
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Ventilators |
Ventilators may be covered for these conditions:
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