Medical Policy Updates

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Notification of Policy Revisions Effective August 24, 2021 (Posted June 15, 2021)

Medical Policy Revision
Oscillatory Devices for the Treatment of Respiratory Conditions "Notification" References added. Volara™ System added to Regulatory Status. When not covered section updated with Volara System Oscillation and Lung Expansion is investigational. Specialty Matched Consultant Advisory Panel review 3/2021. Medical Director review 3/2021. Policy noticed 6/15/2021 for effective date 8/24/2021.
Percutaneous Electrical Nerve Stimulation (PENS) or Neuromodulation Therapy "Notification" Policy statement added that PENFS, including IB-stim, is considered investigational. Policy Guidelines updated. References added. Medical Director review. Title changed from Percutaneous Electrical Nerve Stimulation (PENS) or Neuromodulation Therapy to Percutaneous Electrical Nerve Stimulation (PENS) or Neuromodulation Therapy and Percutaneous Electrical Nerve Field Stimulation (PENFS). Notification given 6/15/2021 for policy effective date 8/24/2021.