Local Coverage Determination · DME MAC
L33785
High Frequency Chest Wall Oscillation Devices
Version 40. CMS effective date 10/01/2022. CMS updated 11/11/2022. Read from the CMS Coverage API on 2026-10-13. Contractors on the report: CGS Administrators (DME MAC) and Noridian Healthcare Solutions (DME MAC).
Coverage indication
In addition to the "reasonable and necessary" criteria contained in this LCD there are other payment rules, which are discussed in the following documents, that must also be met prior to Medicare reimbursement: The LCD-related Standard Documentation Requirements Article, located at the bottom of this policy under the Related Local Coverage Documents section. The LCD-related Policy Article, located at the bottom of this policy under the Related Local Coverage Documents section. Refer to the Supplier Manual for additional information on documentation requirements. Refer to the DME MAC web sites for additional bulletin articles and other publications related to this LCD. For the items addressed in this LCD, the "reasonable and necessary" criteria, based on Social Security Act § 1862(a)(1)(A) provisions, are defined by the following coverage indications, limitations and/or medical necessity. High frequency chest wall oscillation devices (HFCWO) (E0483) are covered for beneficiaries who meet: Criterion 1, 2, or 3, and There is a diagnosis of cystic fibrosis (refer to the ICD-10 code list in the LCD-related Policy Article for applicable diagnoses). There is a diagnosis of bronchiectasis (refer to the ICD-10 code list in the LCD-related Policy Article for applicable diagnoses) which has been confirmed by a high resolution, spiral, or standard CT scan and which is characterized by: Daily productive cough for at least 6 continuous months; or Frequent (i.e., more than 2/year) exacerbations requiring antibiotic therapy.
Excerpt from the LCD indication. Full text on CMS.
Documentation requirements
Items covered in this LCD have additional policy-specific requirements that must be met prior to Medicare reimbursement. Refer to the LCD-related Policy article, located at the bottom of this policy under the Related Local Coverage Documents section for additional information.
Related articles
- A55426 · Standard Documentation Requirements for All Claims Submitted to DME MACs
- A52494 · High Frequency Chest Wall Oscillation Devices - Policy Article
HCPCS codes on this LCD
1 other Level II codes are on the LCD and are not given a page in this set: A7026.
Questions
What does LCD L33785 cover?
L33785 is High Frequency Chest Wall Oscillation Devices. It is a current final DME MAC local coverage determination, version 40.
Where is the CMS source for L33785?
The Medicare Coverage Database page for LCD L33785 version 40.
Get the signed answer via API
The signed answer is the receipt for this code on a date of service: the rule that was in force, with a hash you can replay. The call needs an API key. The source archive and as-of resolution are public.
curl -H "X-API-Key: $VERZI_API_KEY" \
"https://api.verzi.health/v1/rules/warrant?hcpcs=A7025&as_of=2024-01-15&npi=1234567890&state=UT"