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Multi-Function Oscillation Lung Expansion Therapy - MEDICAID - VIRGINIA (Revised)
Effective date
Jul 22, 2026
Identified
Jul 21, 2026
Summary
Humana Medicaid Virginia has clarified that Multi-Function Oscillation Lung Expansion (OLE) therapy devices, including BiWaze Clear System and Volara System (HCPCS E0469), are NOT covered for any indication due to insufficient clinical evidence. This is a non-coverage determination effective 07/22/2026. Billing teams must deny all claims for this service and educate providers that requests will be consistently denied under this plan.
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What to do
Action · 5 steps
01Before 07/22/2026: Billing team must update system edits to automatically deny all claims with HCPCS code E0469 for Humana Medicaid Virginia members.
02Add denial message stating 'Multi-function oscillation lung expansion therapy is not a covered service under this plan.' Update provider communications and Prior Authorization (PA) system to reflect non-coverage status—do NOT process PA requests for E0469.
03Flag any existing pending claims for E0469 and issue denials.
04Notify respiratory therapy and pulmonology providers of the non-coverage determination to prevent future claim submission attempts.
05Document this policy change in billing procedures and staff training materials.
Codes mentioned
E0469
Original notice
Multi-Function Oscillation Lung Expansion Therapy - MEDICAID - VIRGINIA (Revised)
mcp.humana.com · Always check the source before changing claims.