The term "nebulizer" is generally used for the actual chamber in which the nebulization of liquid occurs. In order to achieve a functioning delivery system for aerosol therapy, nebulizers are attached to an aerosol compressor to achieve nebulization by means of airflow. To achieve nebulization by means of ultrasonic vibrations, they are attached to an ultrasonic generator.

Nebulizers are covered when medically necessary for the administration of needed drugs. Accessories (A7005-A7006, A7009, A7012-A7015), such as a mouthpiece (A7016) and tubing (A7010, A7011), are considered eligible when used with a covered nebulizer.

In addition to glass or plastic nebulizers (A7017, E0580), disposable nebulizers are available in large and small sizes. Small volume disposable nebulizers (A7004) and accessories (A7003) used with them are eligible. However, large volume disposable nebulizers (A7007 and A7008) are considered convenience items, and therefore, are noncovered.

A large volume, non-disposable pneumatic nebulizer (E0580) and water or saline (A7018 or A7020) are not separately payable and should not be separately billed when used for patients with rented home oxygen equipment (E0424 and E0439).

See Medical Policy Bulletin E-11, Oxygen Concentrators and Related Durable Medical Equipment, for information on nebulizers/regulators billed in conjunction with oxygen concentrators.

NOTE:

Total payments for a rental item may not exceed its allowable purchase price, except for those items identified as life sustaining DME. For information on continuous rental of life sustaining DME, see Medical Policy Bulletin E-38, Continuous Rental of Life Sustaining Durable Medical Equipment (DME).

PRN References

12/1999, Nebulizers