Medicare Policy Requirements

High frequency chest wall oscillation (HFCWO) devices are covered for patients who meet either criteria 1 or 2, and criteria 3.

  1. There is a documented diagnosis of cystic fibrosis OR
  2. There is a diagnosis of bronchiectasis
    1. Characterized by frequent exacerbations (i.e., 3 or more/year) requiring antibiotic therapy, and
    2. Confirmed by CT scan
    AND
  3. There must be well-documented failure of standard treatments to adequately mobilize retained secretions

Diagnoses Not Included in the Medicare Coverage Policy

The stated coverage criteria represent the circumstances under which Medicare will usually cover the item. However, the policies do not include every possible acceptable indication.

Other indications can be considered for coverage only if there is detailed documentation of the medical necessity in the individual case. Some of the information likely to be pertinent would be: a pulmonary condition relating to the need for the Vest® System, complicating medical conditions, functional abilities and limitations, the overall course of the condition, description of and response to prior treatment, physical limitations, test results, etc.