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AFFLOVEST PRESCRIPTION AND CERTIFICATE OF MEDICAL NECESSITY General Patient Information First Name Last Name Gender Date of Birth Address City State ZIP Code Email Phone SS# Primary Diagnosis Code.

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SmartVest is covered by private insurance, Medicare, state medical assistance, a combination of all three, or the U.S. Department of Veterans Affairs. Our goal is to make prescribing SmartVest easy by working directly with insurance providers.

DIAGNOSIS. Patient must be diagnosed with a condition such as Bronchiectasis (which has been confirmed by a CT scan), or Cystic Fibrosis, Multiple Sclerosis, Muscular Dystrophy or other neuromuscular diseases (View a full list of Medicare approved ICD10 Codes for HFCWO E0483 here).

The AffloVest has received the FDA's 510k clearance for U.S. market availability, and is approved for Medicare, Medicaid, and private health insurance reimbursement under the Healthcare Common Procedure Coding System (HCPCS) code E0483 – High Frequency Chest Wall Oscillation.

Contra-indication to using AffloVest including lung malignancy, recent rib fractures, radiological evidence of lung cavitation, and recent significant haemoptysis (in the opinion of the investigator)

Unlike other HFCWO vests, the AffloVest features built-in oscillating compressor modules that allow for freedom of movement to travel, go for a walk in the park, move around the house, or relax in front of the television....Buy. RATES$475.00/moAVAILABILITYUnited States4 more rows

AffloVest requires a doctor's prescription for treatment by High Frequency Chest Wall Oscillation (HFCWO).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232