CMS makes change to multi-function vents permanent

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Tuesday, June 9, 2020

WASHINGTON – Starting April 20, CMS permanently suspended claims editing for multi-function ventilators when there are claims for separate devices in history that have not met their reasonable useful lifetime, according to a revised MLN Matters article.

Effective immediately, DME suppliers may provide and bill for multi-function vents described by code E0467 as an upgrade in situations where beneficiaries only meet the coverage criteria for a vent.

Ventec Life Systems, which makes the VOCSN multi-function vent, applauded CMS’s decision.

“We thank CMS for making this impactful change to E0467 to ensure access to the benefits of integrated respiratory care for ventilator users and their care partners,” said CEO Chris Kiple. “VOCSN is designed to free families from the complexity of managing and transporting five separate medical devices by providing everyday mobility and the convenience to complete every therapy in seconds at the touch of a button. Every family now has the right to benefit from this technology.”

CMS first allowed expanded use of multi-function vents earlier this year.

Previously, to meet the medical necessity coverage for multi-function vents, CMS required beneficiaries to need a vent and at least one of the four additional functions (oxygen concentrator, cough simulator, suction pump and nebulizer).