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24.5.27.4 Secretion Clearance Devices
Incentive Spirometer
Incentive spirometers, including electronic spirometers, are not a benefit of the Home Health Services.
Intermittent Positive-Pressure Breathing (IPPB) Devices
Intermittent positive-pressure breathing is the application of positive pressure, frequently with aerosols or humidity, to a spontaneously breathing client, as a short-term treatment. Each treatment usually does not last more than 15 or 20 minutes.
IPPB devices require prior authorization.
The IPPB machine may be reimbursed for rental only, and that rental is limited to once per month for a maximum of four months per lifetime.
Rental of the IPPB device includes all supplies, such as humidification and tubing.
Use procedure code L-E0500 when billing for the IPPB.
Purchase of the IPPB device (J-E0500) is not a benefit.
The IPPB device may be authorized for the following diagnoses:
Other diagnoses may be considered based on review of documentation by HHSC or its designee.
Mucous Clearance Valve
The mucous clearance valve is a small handheld device that provides positive expiratory pressure (PEP) therapy for clients who have chronic obstructive pulmonary disease (COPD), chronic bronchitis, cystic fibrosis, atelectasis, or other conditions producing retained secretions.
The mucous clearance valve requires prior authorization.
The mucous clearance valve is age-restricted to 6 years of age and older.
The mucous clearance valve may be reimbursed for purchase only, and that purchase is limited to one every five years.
Use procedure code J-S8185 for the purchase of a mucous clearance valve.
The mucous clearance valve will be reimbursed for the following diagnosis codes only:
Other diagnoses may be considered based on review of documentation by HHSC or its designee.
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