23 Miss. Code. R. 209-1.51 - Humidifier/Vaporizer

A. Medicaid defines a humidifier, heated or non-heated, as a device used to increase the moisture content of the air.

B. Medicaid covers humidifiers for all beneficiaries when ordered by a physician, medically necessary and prior authorized by the Utilization Management and Quality Improvement Organization (UM/QIO), the Division of Medicaid or designated entity for rental up to the purchase amount or for purchase.

C. Room Humidifiers and Vaporizers

1. Medicaid defines a room humidifier as a mechanical device used to increase the moisture content of the air in a room with a cool mist. Medicaid defines a steam vaporizer as a mechanical device that creates moisture in the air by heating the water into a hot mist. Medicaid defines a warm mist humidifier as a type of steam vaporizer that cools the moist steam before it is released into the room.

2. Room humidifiers and vaporizers are covered for beneficiaries who have a chronic diagnosis(es) indicating a respiratory condition in which ease of breathing could be facilitated by increasing the moisture content of the air. The diagnosis may include, but are not limited to:

a) Chronic bronchitis,

b) Asthmatic bronchitis,

c) Chronic Asthma,

d) Bronchopulmonary dysplasia, or

e) Chronic airway obstruction.

3. Documentation must be provided that the patient or caregiver is able to use and care for the equipment.

4. Humidifiers are not covered for acute upper respiratory infections, a chronic cough or colds unrelated to another diagnosis.

D. Medicaid defines a heat and moisture exchanger (HME), or an artificial nose, as a passive acting humidifier that collects expired heat and moisture and returns it during the following inspiration. The HME is covered when the beneficiary has:

1. An existing tracheostomy, and

2. Documentation that supplemental, direct humidification is required for the beneficiary's tracheostomy.

E. High-Flow or Water Reservoir Humidifiers

1. High-Flow, water reservoir, heated or non-heated humidifiers include, but are not limited to pass-over, wick, and bubble types. High-flow and water reservoir humidifiers are used to provide supplemental heat and humidity and are covered as follows:

a) The use of high-flow, water reservoir humidifiers to increase moisture to the airway of a beneficiary with a tracheostomy is covered when the beneficiary has an existing tracheostomy and documentation is present that the beneficiary requires supplemental, direct humidification to the tracheostomy.

b) A high-flow, water reservoir humidifier is covered for C-PAP and Bi-PAP devices if criteria for coverage of the C-PAP or BI-PAP device are satisfied and documentation is present that the beneficiary requires supplemental humidification.

c) A high-flow, water reservoir humidifier is covered in conjunction with ventilators if criteria for coverage of the ventilator are satisfied and documentation is present that the beneficiary requires supplemental humidification.

2. Humidifiers are included in the rental or purchase price of that equipment when used in conjunction with oxygen or IPPB treatments.

Notes

23 Miss. Code. R. 209-1.51

Miss. Code Ann. § 43-13-121.

01/01/2013 Amended 9/1/2018