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Non-invasive Positive Pressure Ventilators (In-Home Use) BlueCross BlueShield of Tennessee Medical Policy Manual Non-invasive Positive Pressure Ventilators (In-Home Use) DESCRIPTION A non-invasive positive pressure ventilator (NIPPV) provides ventilatory support through a non-invasive interface, such as a nasal mask, full-face mask or helmet. NIPPV is utilized in the acute care setting as short-term life support therapy for respiratory conditions that generally respond relatively quickly to therapy (e.g. Acute-on-chronic respiratory failure, COPD, post-op respiratory distress).
Evidence-based data demonstrates that use of NIPPV in hospitalized individuals reduces mortality and morbidity associated with invasive (e.g. Endotracheal or tracheotomy) mechanical ventilation (e.g. Nosocomial infections, pneumonia, and length of hospital stay). NIPPV during an acute exacerbation is often applied intermittently or continuously to reduce the (life-threatening) ventilatory failure while simultaneously administering medical therapeutics.
Following optimal recovery the individuals is weaned and NIPPV treatment is terminated. NIPPV can also be useful in the weaning process from invasive mechanical ventilation. Recently NIPPV has been explored for use in the homecare environment (e.g. Trilogy™, Newport™, VELA®, iVent, Puritan Bennett 540™, and LTV®). Home NIPPV may be employed in continuous daily use for ventilator dependent individuals (e.g. Neuromuscular diseases). It is also being investigated as an intermittent treatment for other chronic respiratory diseases (e.g., chronic obstructive pulmonary disease, obesity hypoventilation syndrome, diffuse parenchymal lung disease) and nocturnal respiratory insufficiency.
This policy does not address other respiratory assist devices (e.g. CPAP, BiPAP) POLICY. Kawasaki zzr 250 service manual 03. Home non-invasive positive pressure ventilators (e.g.
Trilogy™, Newport™, VELA®, iVent, Puritan Bennett 540™, and LTV®) for the treatment of respiratory insufficiency associated with progressive neuromuscular disease (e.g., muscular dystrophy, myasthenia gravis, polio) are considered medically necessary if the medical appropriateness criteria are met. (See Medical Appropriateness below.). Home non-invasive positive pressure ventilators (e.g. Trilogy™, Newport™, VELA®, iVent, Puritan Bennett 540™, and LTV®) for the treatment of obstructive sleep apnea are considered not medically necessary. The clinical outcomes with this treatment have not been shown to be superior to other approaches (e.g., CPAP, BiPAP) and non-invasive positive pressure ventilators are generally more costly than these alternatives. Home use of a non-invasive positive pressure ventilators (e.g. Trilogy™, Newport™, VELA®, iVent, Puritan Bennett 540™, and LTV®) for the treatment of other conditions/diseases including but not limited to chronic obstructive pulmonary disease (COPD) are considered investigational.
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Any device utilized for this procedure must have FDA approval specific to the indication, otherwise it will be considered investigational.