National Coverage Determination (NCD)

Intrapulmonary Percussive Ventilator (IPV)

240.5

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Tracking Information

Publication Number
100-3
Manual Section Number
240.5
Manual Section Title
Intrapulmonary Percussive Ventilator (IPV)
Version Number
1
Effective Date of this Version
07/14/1997

Description Information

Benefit Category
Durable Medical Equipment


Please Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

Item/Service Description

IPV is a mechanized form of chest physical therapy. Instead of a therapist clapping or slapping the patient's chest wall, the IPV delivers mini-bursts (more than 200 per minute) of respiratory gasses to the lungs via a mouthpiece. Its intended purpose is to mobilize endobronchial secretions and diffuse patchy atelectasis. The patient controls variables such as inspiratory time, peak pressure and delivery rates.

Indications and Limitations of Coverage

Studies do not demonstrate any advantage of IPV over that achieved with good pulmonary care in the hospital environment and there are no studies in the home setting. There are no data to support the effectiveness of the device. Therefore, IPV in the home setting is not covered.

Transmittal Information

Transmittal Number
100
Revision History

04/1997 - Provided that home use is not covered. Effective date 05/14/1997. (TN 95)

05/1997 - Changed effective date of TN 95 to 07/14/1997. Effective date 07/14/1997. (TN 100)

Additional Information

Other Versions
Title Version Effective Between
Intrapulmonary Percussive Ventilator (IPV) 1 07/14/1997 - N/A You are here