VERZIHEALTHGet a key
Coverage Knowledge Base

Every policy word on this page is CMS's own. Verzi adds pins, receipts, and links only.

Mechanical In-exsufflation Devices - Policy Article

Article A52510 · 40 versions, 2015 to today · last changed 2025-10-01 (R20)

Version 25 of Article A52510: in force by CMS's dates 2020-04-03 to 2020-04-02. The policy text on this page comes from this archived version.

DME MAC jurisdictions
JA · Noridian 16013
CT, DE, DC, ME, MD, MA, NH, NJ, NY, PA, RI, VT
JB · CGS 17013
IL, IN, KY, MI, MN, OH, WI
JC · CGS 18003
AL, AR, CO, FL, GA, LA, MS, NM, NC, OK, PR, SC, TN, TX, VI, VA, WV
JD · Noridian 19003
AK, AS, AZ, CA, GU, HI, ID, IA, KS, MO, MT, NE, NV, ND, MP, OR, SD, UT, WA, WY
source

CMS's Who are the MACs jurisdiction pages (DME facts as of 2025-09-30) name each contractor and its states; the MCD's Contractor Information table on every DME LCD prints the contract numbers. Both read 2026-10-09. Verzi adds the state lookup only.

You are viewing version 25 (2020-04-03, superseded same day). Version 61 is in force today.

Sections in this version: Article Text · Coding Information. Plus 1 section marked N/A in this version.

Full verbatim text serves to customers · Customer? Log in

Version history, Article A52510

CMS numbers each version. Each box shows the version's window by CMS's stated dates. Select a version to show it on this page. Versions superseded the same day they took effect never governed a claim, so the page hides them until you ask. Version numbers CMS never published to its archive do not exist as documents.

Revision history, every version

CMS's own change log, quoted, 38 entries. It does not change with the version shown. A revision (R-number) is a change CMS logged. The version (vN) is the snapshot that carries it.

R20 · 2025-10-01 · v61
Revision Effective Date: 10/01/2025
ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:
Removed: ICD-10-CM code G35 from Group 1 Codes, due to ICD-10-CM code updates
Added: ICD-10-CM codes G35.A, G35.B0, G35.B1, G35.B2, G35.C0, G35.C1, G35.C2, G35.D, G71.036 to Group 1 Codes, due to ICD-10-CM code updates


09/18/2025: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R19 · 2025-01-23 · v58
Revision Effective Date: 01/23/2025
ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:
Added: ICD-10-CM codes G70.00, G72.49 and G72.9 to Group 1 Codes


01/23/2025: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R18 · 2024-08-08 · v56
Revision Effective Date: 08/08/2024
ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:
Added: ICD-10-CM codes G71.12, G71.13, G71.14, G71.19, G71.3, G71.8, G72.0, G72.1, G72.2, G72.89, G73.7, J98.6, M33.02, M33.12, M33.22, M33.92, M34.82, M35.03 to Group 1 Codes


 08/08/2024: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R18 · 2024-08-08 · v56
Revision Effective Date: 08/08/2024
ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:
Added: ICD-10-CM codes G71.12, G71.13, G71.14, G71.19, G71.3, G71.8, G72.0, G72.1, G72.2, G72.89, G73.7, J98.6, M33.02, M33.12, M33.22, M33.92, M34.82, M35.03 to Group 1 Codes


 08/08/2024: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R17 · 2023-10-01 · v54
Revision Effective Date: 10/01/2023
CODING GUIDELINES:
Removed: Coding and billing information pertaining to multifunction ventilators coded E0467
CODING VERIFICATION REVIEW:
Removed: Section header and PDAC coding verification review (CVR) information, including CVR information pertaining to products coded E0467


05/16/2024: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R17 · 2023-10-01 · v54
Revision Effective Date: 10/01/2023
CODING GUIDELINES:
Removed: Coding and billing information pertaining to multifunction ventilators coded E0467
CODING VERIFICATION REVIEW:
Removed: Section header and PDAC coding verification review (CVR) information, including CVR information pertaining to products coded E0467


05/16/2024: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R16 · 2023-10-01 · v52
Revision Effective Date: 10/01/2023
ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:
Added: ICD-10-CM code E74.05 to Group 1 Codes due to ICD-10-CM code updates


09/21/2023: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R16 · 2023-10-01 · v52
Revision Effective Date: 10/01/2023
ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:
Added: ICD-10-CM code E74.05 to Group 1 Codes due to ICD-10-CM code updates


09/21/2023: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R15 · 2023-05-25 · v49
Revision Effective Date: 05/25/2023
ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:
Added: ICD-10-CM code G80.0 to Group 1 Codes


05/25/2023: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R15 · 2023-05-25 · v49
Revision Effective Date: 05/25/2023
ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:
Added: ICD-10-CM code G80.0 to Group 1 Codes


05/25/2023: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R14 · 2022-10-01 · v47
Revision Effective Date: 10/01/2022
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Added: ICD-10-CM codes G71.031, G71.032, G71.033, G71.0340, G71.0341, G71.0342, G71.0349, G71.035, G71.038, G71.039 to Group 1 Codes due to ICD-10-CM code updates


09/22/2022: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R14 · 2022-10-01 · v47
Revision Effective Date: 10/01/2022
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Added: ICD-10-CM codes G71.031, G71.032, G71.033, G71.0340, G71.0341, G71.0342, G71.0349, G71.035, G71.038, G71.039 to Group 1 Codes due to ICD-10-CM code updates


09/22/2022: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R13 · 2021-10-01 · v44
Revision Effective Date: 10/01/2021
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):
Removed: “The link will be located here once it is available.”
Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list


04/14/2022: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R13 · 2021-10-01 · v44
Revision Effective Date: 10/01/2021
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. REG VOL 217):
Removed: “The link will be located here once it is available.”
Added: “The required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list


04/14/2022: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R12 · 2021-10-01 · v41
Revision Effective Date: 10/01/2021
CODING GUIDELINES:
Revised: Coding instructions for multifunction ventilators (E0467) (Effective 01/01/2019)
CODING VERIFICATION REVIEW:
Added: Section header and PDAC coding verification review (CVR) information
Added: CVR requirement for products coded E0467


11/11/2021: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R12 · 2021-10-01 · v41
Revision Effective Date: 10/01/2021
CODING GUIDELINES:
Revised: Coding instructions for multifunction ventilators (E0467) (Effective 01/01/2019)
CODING VERIFICATION REVIEW:
Added: Section header and PDAC coding verification review (CVR) information
Added: CVR requirement for products coded E0467


11/11/2021: At this time the 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R11 · 2021-10-01 · v35
Revision Effective Date: 10/01/2021
ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:
Revised: ICD-10-CM code description for G71.20 due to annual ICD-10-CM Code updates


10/07/2021: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R11 · 2021-10-01 · v35
Revision Effective Date: 10/01/2021
ICD-10-CM CODES THAT SUPPORT MEDICAL NECESSITY:
Revised: ICD-10-CM code description for G71.20 due to annual ICD-10-CM Code updates


10/07/2021: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R10 · 2020-10-01 · v31
Revision Effective Date: 10/01/2020
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Added: Reimbursement statement for replacement of A7020
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Added: A7020 to Group 1 Paragraph


03/18/2021: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R10 · 2020-10-01 · v31
Revision Effective Date: 10/01/2020
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Added: Reimbursement statement for replacement of A7020
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Added: A7020 to Group 1 Paragraph


03/18/2021: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R9 · 2020-10-01 · v29
Revision Effective Date: 10/01/2020
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Removed: ICD-10 code G71.2 from Group 1, due to annual ICD-10 Code updates
Added: ICD-10 codes G71.20, G71.21, G71.220, G71.228, G71.29 to Group 1 codes, due to annual ICD-10 Code updates


09/24/2020: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R9 · 2020-10-01 · v29
Revision Effective Date: 10/01/2020
ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
Removed: ICD-10 code G71.2 from Group 1, due to annual ICD-10 Code updates
Added: ICD-10 codes G71.20, G71.21, G71.220, G71.228, G71.29 to Group 1 codes, due to annual ICD-10 Code updates


09/24/2020: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R8 · 2020-04-03 · v25
Revision Effective Date: 04/03/2020
CODING GUIDELINES:
Revised: Guidance for billing HCPCS code E0467 based on DOS


07/16/2020: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R8 · 2020-04-03 · v25
Revision Effective Date: 04/03/2020
CODING GUIDELINES:
Revised: Guidance for billing HCPCS code E0467 based on DOS


07/16/2020: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R7 · 2020-01-01 · v21
Revision Effective Date: 01/01/2020
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO 42 CFR 410.38(g):
 Removed: Due to Final Rule 1713
 REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
 Added: Section information based on Final Rule 1713

ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
 Revised: Section header “ICD-10 Codes that are Covered” updated to “ICD-10 Codes that Support Medical Necessity”
 ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
 Revised: Section header “ICD-10 Codes that are Not Covered” updated to “ICD-10 Codes that DO NOT Support Medical Necessity”


 02/06/2020: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R7 · 2020-01-01 · v21
Revision Effective Date: 01/01/2020
REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO 42 CFR 410.38(g):
 Removed: Due to Final Rule 1713
 REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 Fed. Reg Vol 217):
 Added: Section information based on Final Rule 1713

ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:
 Revised: Section header “ICD-10 Codes that are Covered” updated to “ICD-10 Codes that Support Medical Necessity”
 ICD-10 CODES THAT DO NOT SUPPORT MEDICAL NECESSITY:
 Revised: Section header “ICD-10 Codes that are Not Covered” updated to “ICD-10 Codes that DO NOT Support Medical Necessity”


 02/06/2020: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R6 · 2019-01-01 · v16
Revision Effective Date: 01/01/2019

CODING GUIDELINES:
Revised: E0467 Coding Guidelines to include custom fabricated oral appliances


04/04/2019: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R6 · 2019-01-01 · v16
Revision Effective Date: 01/01/2019

CODING GUIDELINES:
Revised: E0467 Coding Guidelines to include custom fabricated oral appliances


04/04/2019: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R5 · 2019-01-01 · v14
Revision Effective Date: 01/01/2019

CODING GUIDELINES:
 Added: E0467 Coding Guidelines
 ICD-10 CODES THAT ARE COVERED:
 Added: All diagnosis codes formerly listed in the LCD
 Added: ICD-10 codes E74.02 and G70.01
 ICD-10 CODES THAT ARE NOT COVERED:
 Added: Notation excluding all unlisted diagnosis codes from coverage


02/21/2019: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R5 · 2019-01-01 · v14
Revision Effective Date: 01/01/2019

CODING GUIDELINES:
 Added: E0467 Coding Guidelines
 ICD-10 CODES THAT ARE COVERED:
 Added: All diagnosis codes formerly listed in the LCD
 Added: ICD-10 codes E74.02 and G70.01
 ICD-10 CODES THAT ARE NOT COVERED:
 Added: Notation excluding all unlisted diagnosis codes from coverage


02/21/2019: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R4 · 2017-01-01 · v11
Revision Effective Date: 01/01/2017
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES
Added: 42 CFR 410.38(g) language, previously in Policy Specific Documentation Requirement section


04/05/2018: At this time 21st Century Cures Act applies to new and revised LCDs that restrict coverage, which require comment and notice. This revision is to an article that is not a local coverage determination
R4 · 2017-01-01 · v11
Revision Effective Date: 01/01/2017
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES
Added: 42 CFR 410.38(g) language, previously in Policy Specific Documentation Requirement section


04/05/2018: At this time 21st Century Cures Act applies to new and revised LCDs that restrict coverage, which require comment and notice. This revision is to an article that is not a local coverage determination
R3 · 2017-01-01 · v8
Revision Effective Date: 01/01/2017
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Added: 42 CFR 410.38(g) requirements
RELATED LOCAL COVERAGE DOCUMENTS:
Added: LCD-related Standard Documentation Requirements Language Article
R3 · 2017-01-01 · v8
Revision Effective Date: 01/01/2017
POLICY SPECIFIC DOCUMENTATION REQUIREMENTS:
Added: 42 CFR 410.38(g) requirements
RELATED LOCAL COVERAGE DOCUMENTS:
Added: LCD-related Standard Documentation Requirements Language Article
R2 · 2016-07-01 · v6
Effective July 1, 2016 oversight for DME MAC Articles is the responsibility of CGS Administrators, LLC 18003 and 17013 and Noridian Healthcare Solutions, LLC 19003 and 16013. No other changes have been made to the Articles.
R2 · 2016-07-01 · v6
Effective July 1, 2016 oversight for DME MAC Articles is the responsibility of CGS Administrators, LLC 18003 and 17013 and Noridian Healthcare Solutions, LLC 19003 and 16013. No other changes have been made to the Articles.
R1 · 2015-10-01 · v3
Revision Effective Date: 10/01/2015
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Removed: “When required by state law” from ACA new prescription requirements
Revised: Face-to-Face Requirements for treating practitioner
R1 · 2015-10-01 · v3
Revision Effective Date: 10/01/2015
NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:
Removed: “When required by state law” from ACA new prescription requirements
Revised: Face-to-Face Requirements for treating practitioner
Receipts for auditors

Version 25 of Article A52510, shown on this page: in force by CMS's dates 2020-04-03 to 2020-04-02. Archived 2026-09-26. CMS's copy · Our archived file. 3 of 3 sections are proven word-identical to the archived file.

Every archived version of Article A52510 (40 versions, CMS's dates, window by the as-of rule).

DocumentVersionIn forceArchived onVerify
Article A52510version 22015-10-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 22015-10-01, superseded same day2026-10-02CMS's copy · Our archived file
Article A52510version 32015-10-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 32015-10-01 to 2016-06-302026-10-02CMS's copy · Our archived file
Article A52510version 62016-07-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 62016-07-01 to 2016-12-312026-10-02CMS's copy · Our archived file
Article A52510version 82017-01-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 82017-01-01, superseded same day2026-10-02CMS's copy · Our archived file
Article A52510version 112017-01-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 112017-01-01 to 2018-12-312026-10-02CMS's copy · Our archived file
Article A52510version 142019-01-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 142019-01-01, superseded same day2026-10-02CMS's copy · Our archived file
Article A52510version 162019-01-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 162019-01-01 to 2019-12-312026-10-02CMS's copy · Our archived file
Article A52510version 212020-01-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 212020-01-01 to 2020-04-022026-10-02CMS's copy · Our archived file
Article A52510version 25 shown2020-04-03, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 252020-04-03 to 2020-09-302026-10-02CMS's copy · Our archived file
Article A52510version 292020-10-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 292020-10-01, superseded same day2026-10-02CMS's copy · Our archived file
Article A52510version 312020-10-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 312020-10-01 to 2021-09-302026-10-02CMS's copy · Our archived file
Article A52510version 352021-10-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 352021-10-01, superseded same day2026-10-02CMS's copy · Our archived file
Article A52510version 412021-10-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 412021-10-01, superseded same day2026-10-02CMS's copy · Our archived file
Article A52510version 442021-10-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 442021-10-01 to 2022-09-302026-10-02CMS's copy · Our archived file
Article A52510version 472022-10-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 472022-10-01 to 2023-05-242026-10-02CMS's copy · Our archived file
Article A52510version 492023-05-25, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 492023-05-25 to 2023-09-302026-10-02CMS's copy · Our archived file
Article A52510version 522023-10-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 522023-10-01, superseded same day2026-10-02CMS's copy · Our archived file
Article A52510version 542023-10-01, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 542023-10-01 to 2024-08-072026-10-02CMS's copy · Our archived file
Article A52510version 562024-08-08, superseded same day2026-09-26CMS's copy · Our archived file
Article A52510version 562024-08-08 to 2025-01-222026-10-02CMS's copy · Our archived file
Article A52510version 582025-01-23 to 2025-09-302026-10-02CMS's copy · Our archived file
Article A52510version 612025-10-01 to today2026-09-26CMS's copy · Our archived file

Each archived file's page gives its sha256 fingerprint. A copy of the file hashes to the same value, byte for byte.

CMS's live page shows only the current version. To check a passage by eye, open CMS's copy of the same version number. A version's window ends on the earlier of CMS's stated end date and the day before the next version starts.

Every policy word on this page is CMS's, from the archived version named beside it. Verzi adds labels, highlights, citations and links only. Verzi-written summary content on this page: none.