Local Coverage Determination · DME MAC
L33795
Mechanical In-exsufflation Devices
Version 29. CMS effective date 01/01/2020. CMS updated 02/13/2020. 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. Mechanical in-exsufflation devices (E0482) are covered for beneficiaries who meet all of the following criteria; They have a neuromuscular disease (refer to the ICD-10 code list in the LCD-related Policy Article for applicable diagnoses), and This condition is causing a significant impairment of chest wall and/or diaphragmatic movement, such that it results in an inability to clear retained secretions. If both of these criteria are not met, the claim will be denied as not reasonable and necessary. A Standard Written Order (SWO) must be communicated to the supplier before a claim is submitted.
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 to justify 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
- A52510 · Mechanical In-exsufflation Devices - Policy Article
HCPCS codes on this LCD
Questions
What does LCD L33795 cover?
L33795 is Mechanical In-exsufflation Devices. It is a current final DME MAC local coverage determination, version 29.
Where is the CMS source for L33795?
The Medicare Coverage Database page for LCD L33795 version 29.
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=A7020&as_of=2024-01-15&npi=1234567890&state=UT"