Pulmonology Coding Alert

Question: How should I report a therapy using The Vest® airway clearance system? A therapist stays with the patient during the therapy session which usually lasts for 20 minutes twice a day.

Connecticut Subscriber

Answer: Only a nonfacility can bill the Vest because it is a reusable device aimed at treating lobes of the lungs simultaneously. This device mimics manual chest percussion therapy, but is technology dependent on high-frequency chest wall oscillation (HFCWO).

Pulmonologist would order Vest therapy for patients with cystic fibrosis (277.00-277.09) and tuberculous bronchiectasis (011.50- 011.55). Demonstration or use of this device that replace, rather than assist, hands-on-therapy (e.g., high frequency chest wall oscillation system vest) should not currently be reported with 94667-94668 (Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function...). Instead, consider demonstration of such devices a component of any other billable service on a given date. However, you could bill the HCPCS code E0483 (High frequency chest wall oscillation air-pulse generator system, [includes hoses and vest], each) for using the Vest system, and A7025 (High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each) for the garment.