Aerosol Therapy Coverage Criteria Medicare Payment and Coverage Rules A Nebulizer Compressor (E0570) is covered when: a)  It is medically necessary to administer beta-adrenergics, anitcholinergics,   corticosteroids, and cromolyn for the management of obstructive pulmonary disease (ICD-9 diagnosis codes 491.0 - 505), or      491.0     Chronic Bronchitis      492.8     Emphysema      493.9     Asthma      494        Bronchiectasis      496        COPD/COAD      500        Black Lung b)  It is medically necessary to administer gentamicin, tobramycin, amikacin, or dornase alfa to a patient with cystic fibrosis (ICD-9 diagnosis code 277.00) or c)  It is medically necessary to administer pentamidine to patients with HIV  (ICD-9 diagnosis code 042), pneumocystosis (ICD-9 diagnosis code 136.3), and complications of organ transplants (ICD-9 diagnosis codes 996.8 - 996.89), or d)  It is medically necessary to administer mucolytics (other than dornase alpha) for persistent thick or tenacious pulmonary secretions (ICD-9 diagnosis code 786.4). Use of inhalation drugs, other than those listed above, will be denied as not medically necessary. For criterion (a) to be met, the physician must have considered use of a metered dose inhaler (MDI) with and without a reservoir or spacer device and decided that, for medical reasons, it was not sufficient for the administration of needed inhalation drugs.  The reason for requiring a small volume nebulizer and related compressor instead of or in addition to an MDI must be documented in the patient's medical record and be available to the DMERC on request. If none of the drugs used with a nebulizer are covered, the nebulizer and its supplies will be denied as not medically necessary.