Key facts for NCD 240.5
- Benefit category
- Durable Medical Equipment
- Effective date
- 07/14/1997
- Transmittal
- Transmittal 100
- Versions published
- 1
- Manual chapter
- 240
- NCD Manual (Pub. 100-03)
TL;DR
NCD 240.5 sets Medicare's national policy for intrapulmonary percussive ventilator (ipv) under the benefit category "Durable Medical Equipment", effective 07/14/1997. Studies do not demonstrate any advantage of IPV over that achieved with good pulmonary care in the hospital environment and there are no studies in the home setting. There are no data to support the effectiveness of the device. Therefore, IPV in the home… It has been revised once since publication and binds every Medicare Administrative Contractor nationally.
Item or service described
IPV is a mechanized form of chest physical therapy. Instead of a therapist clapping or slapping the patient's chest wall, the IPV delivers mini-bursts (more than 200 per minute) of respiratory gasses to the lungs via a mouthpiece. Its intended purpose is to mobilize endobronchial secretions and diffuse patchy atelectasis. The patient controls variables such as inspiratory time, peak pressure and delivery rates.
Indications and limitations of coverage
Studies do not demonstrate any advantage of IPV over that achieved with good pulmonary care in the hospital environment and there are no studies in the home setting. There are no data to support the effectiveness of the device. Therefore, IPV in the home setting is not covered.
Text reproduced from the CMS Medicare Coverage Database record for NCD 240.5 version 1. View the original on cms.gov.
Revision history
05/1997 - Changed effective date of TN 95 to 07/14/1997. Effective date 07/14/1997. (TN 100)
04/1997 - Provided that home use is not covered. Effective date 05/14/1997. (TN 95)
How this NCD shows up on remittances
A service denied under a National Coverage Determination returns CARC 50 (not deemed medically necessary) with remark N386 (decision based on an NCD); a denial citing a local policy instead carries N115. Because NCDs bind nationally, the appeal path is documentation that the patient meets the indications above, not a contractor-policy argument.
How QuickIntell applies NCD 240.5
QuickAuth checks the ordered service and diagnosis against NCD and LCD criteria before the encounter, QuickCode validates the diagnosis pairing on the claim, and QuickRCM routes CARC 50 denials with the policy text and the covered-code list attached so the appeal starts with evidence.
Frequently asked questions — NCD 240.5
What does NCD 240.5 cover?
Studies do not demonstrate any advantage of IPV over that achieved with good pulmonary care in the hospital environment and there are no studies in the home setting. There are no data to support the effectiveness of the device. Therefore, IPV in the home setting is not covered. The full indications and limitations are reproduced on this page from the CMS Medicare Coverage Database.
When did NCD 240.5 take effect?
The current version (1) is effective 07/14/1997, published in transmittal 100. This is the only published version.
Does a Local Coverage Determination override NCD 240.5?
No. A National Coverage Determination binds all Medicare Administrative Contractors; an LCD can only address services or circumstances the NCD leaves open. Claims denied under this NCD typically return CARC 50 with remark N386 (NCD) rather than N115 (LCD).
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.
- Medicare Coverage Database NCDs via the CMS Coverage APIVersion API snapshot 2026-09-27 · effective 2026-09-20 · file national-coverage-ncd.jsonSHA-256 a90fadfd264b9ef4…
Disclaimer
This page reproduces the CMS National Coverage Determination text and, for laboratory NCDs, the CMS ICD-10 edit lists, as an operational reference. Coverage decisions depend on the full policy, the claim and the contractor; nothing here is legal, clinical or billing advice. CPT codes are shown as numbers only; CPT descriptors are copyright AMA.