title: The changing landscape of adult home noninvasive ventilation technology, use, and reimbursement in the United States.
abstract: There has been an exponential increase in the use of home noninvasive ventilation (NIV). Despite growing use, there is a paucity of evidence-based guidelines and practice standards in the United States to assist clinicians in the initiation and ongoing management of home NIV. Consequently, home NIV practices are being influenced by complicated local reimbursement policies and coding. This article aims to provide a practice management perspective for clinicians providing home NIV, including Local Coverage Determination reimbursement criteria for respiratory assist devices, Durable Medical Equipment coding, and Current Procedural Terminology coding to optimize clinical care and minimize lost revenue. It highlights the need for further research and development of evidence-based clinical practice standards to ensure best practice policies are in place for this rapidly evolving patient population.
authors.affiliation: Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address: bernie.sunwoo@uphs.upenn.edu.
authors.forename: Bernie Y
authors.initials: BY
authors.lastname: Sunwoo
authors.affiliation: Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA.
authors.forename: Mary
authors.initials: M
authors.lastname: Mulholland
authors.affiliation: Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Ilene M
authors.initials: IM
authors.lastname: Rosen
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Lisa F
authors.initials: LF
authors.lastname: Wolfe
mesh_terms: D000328:Adult; D004389:Durable Medical Equipment / Q000191:economics; D004867:Equipment Design; D006699:Home Care Services; D006801:Humans; D063087:Noninvasive Ventilation / Q000191:economics / Q000295:instrumentation / Q000706:statistics & numerical data; D012051:Reimbursement Mechanisms / Q000191:economics*; D012891:Sleep Apnea Syndromes / Q000191:economics / Q000628:therapy*; D014481:United States