E0480 Percussor elect/pneum home mPercussor, electric or pneumatic, home model
2 of 2 payer prior-auth lists that name E0480 require prior authorization or set conditions: Humana, Passport by Molina Healthcare (Kentucky).
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Humana | Humana Healthy Horizons | VA | prior auth required | Jan 1, 2027 | Humana Healthy Horizons in Virginia Prior Authorization and Notification List (PAL) | |
| Passport by Molina Healthcare (Kentucky) | Medicaid | KY | prior auth under conditions | State exception; PA above quantity limits | Jul 1, 2026 | Kentucky Medicaid Prior Auth (PA) Code Matrix and Kentucky PA Code Exceptions, effective Q3 2026 |
E0480 appears in 3 coverage policies from Aetna, Blue Shield of California.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Chest Physiotherapy and Airway Clearance Devices (0067) | covered if criteria are met | Mar 18, 2026 | payer document |
| Aetna | Pulse Oximetry and Capnography for Home Use (0339) | listed, no stance (range E0455-E0484) | May 21, 2026 | payer document |
| Blue Shield of California | Oscillatory Devices for the Treatment of Cystic Fibrosis and Other Respiratory Conditions (1.01.15) | listed, no stance | payer document |
Prior authorization required or conditional in CO, IL, IN, KY, LA, MA, MS, ND, NY, VA, WV.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.