BlueCross BlueShield of Tennessee Medical Policy Manual

Oscillating Devices for the Treatment of Respiratory Conditions

DESCRIPTION

Oscillatory devices are intended to promote the clearance of respiratory secretions. These devices include high-frequency chest compression with an inflatable vest, oscillating positive expiratory pressure devices, and intrapulmonary percussive ventilation. These devices have been primarily investigated as an alternative (not adjunct) to the standard daily percussion and postural drainage method of airway clearance for individuals with cystic fibrosis. They have been proposed for use in other respiratory conditions such as chronic obstructive pulmonary disorder (COPD), bronchiectasis, or neuromuscular conditions. The oscillatory component can be intra-or extrathoracic.

POLICY

MEDICAL APPROPRIATENESS

IMPORTANT REMINDERS

ADDITIONAL INFORMATION 

The use of high-frequency chest wall compression and home use of intrapulmonary percussive ventilation devices in other chronic pulmonary diseases, such as chronic obstructive pulmonary disorder, is considered investigational due to insufficient evidence on the impact of treatment on health outcomes.

SOURCES 

American College of Chest Physicians. (2006, January). Nonpharmacologic airway clearance therapies. Retrieved November 13, 2018 from https://journal.chestnet.org/article/S0012-3692(15)52857-2/fulltext.

BlueCross BlueShield Association. Medical Policy Reference Manual. (6:2018). Oscillatory devices for the treatment of cystic fibrosis and other respiratory disorders (1.01.15). Retrieved November 12, 2018 from BlueWeb. (17 articles and/ or guidelines reviewed)

Cystic Fibrosis Foundation. (2009). CF airway clearance therapies clinical care guidelines. Retrieved November 12, 2018 from https://www.cff.org/Care/Clinical-Care-Guidelines/Respiratory-Clinical-Care-Guidelines/CF-Airway-Clearance-Therapies-Clinical-Care-Guidelines/.

Lauwers, E., Ides, K., Van Hoorenbeeck, K., & Verhulst, S. (2018). The effect of intrapulmonary percussive ventilation in pediatric patients: a systematic review. Pediatric Pulmonology, 53 (11), 1463-1474. Abstract retrieved November 15, 2018 from PubMed database.

Lee, A. L., Burge, A. T., & Holland, A. E. (2015). Airway clearance techniques for bronchiectasis. Cochrane Database System Review, 2015, (11). Abstract retrieved January 3, 2017 from PubMed database.

McIlwaine, M., Button, B., & Dwan, K. (2015). Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis. Cochrane Database System Review, 2015, (6). Abstract retrieved January 3, 2017 from PubMed database.

Morrison, L., & Agnew, J. (2014). Oscillating devices for airway clearance in people with cystic fibrosis. Cochrane Database System Review, 2014, (7). Abstract retrieved January 3, 2017 from PubMed database.

U. S. Food and Drug Administration. (2005, December). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K053248 (ElectroMed SmartVest®). Retrieved August 19, 2011 from http://www.accessdata.fda.gov.

U. S. Food and Drug Administration. (2007, March). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K063645 (Frequencer™) Retrieved August 19, 2011 from http://www.accessdata.fda.gov.

U. S. Food and Drug Administration. (2010, January). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K091557. Retrieved August 19, 2011 from http://www.accessdata.fda.gov.

Winifred S. Hayes. Medical Technology Directory. (2016, December; last update search December 2017). High-frequency chest wall compression for cystic fibrosis. Retrieved November 12, 2018 from www.Hayesinc.com/subscribers. (77 articles and/or guidelines reviewed)

Yuan, N., Kane, P., Shelton, K., Matel, J., Becker, B., & Moss, R. (2010). Safety, tolerability, and efficacy of high-frequency chest wall oscillation in pediatric patients with cerebral palsy and neuromuscular diseases: an exploratory randomized controlled trial. Journal of Child Neurology, 25 (7), 815-821. (Level 3 evidence)

ORIGINAL EFFECTIVE DATE:  10/25/2001

MOST RECENT REVIEW DATE:  4/30/2019

ID_BT

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