MedicaidCoverageMedium impact
Multi-Function Oscillation Lung Expansion Therapy - MEDICAID - VIRGINIA (Revised)
Humana·VA · Pulmonology, Critical Care·Medicaid
We identified it
Jul 21, 2026
Summary
Humana Medicaid Virginia has issued a revised policy on Multi-Function Oscillation Lung Expansion (OLE) therapy devices, clarifying that these are noncontinuous respiratory support devices designed to provide lung expansion and airway clearance therapy. The policy defines OLE devices as delivering alternating modes of positive pressure to clear retained lung secretions and improve lung expansion. Billing teams must verify coverage criteria and any prior authorization requirements for these devices under this revised guidance.
Action Required
Immediately: Billing team must review the complete Multi-Function Oscillation Lung Expansion Therapy policy from Humana Medicaid Virginia (source: https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a58451c) to obtain: (1) specific CPT/HCPCS billing codes covered under this policy, (2) prior authorization requirements and submission process, (3) medical necessity documentation standards, (4) any coverage limitations or exclusions. Update billing system rules and encounter forms accordingly. Contact Humana Medicaid Virginia directly at the provided URL or through your provider portal to request the full policy document, as the summary provided does not include specific billing codes, effective dates, or coverage criteria needed for accurate claim processing. Do not bill for OLE therapy until coverage parameters are confirmed.