U.S. Reimbursement Resources
Pulmonx is dedicated to supporting healthcare providers, associated facilities and their patients as they navigate through the reimbursement process and educate payers on the Zephyr® Valve procedure. Commonly requested information related to the reimbursement process for the Zephyr Valve procedure is provided below.
For providers or hospitals interested in speaking with a reimbursement representative in more detail about reimbursement associated with the Zephyr Valve procedure, please contact us.
Approved Indication
The Pulmonx Zephyr Valves are implantable bronchial valves indicated for the bronchoscopic treatment of adult patients with hyperinflation associated with severe emphysema in regions of the lung that have little to no collateral ventilation.
Published clinical evidence can be found by clicking the button below.
Coding
For additional information about possible coding and payment related to the Zephyr Valve procedure, download a copy of the Pulmonx Coding Guide here.
Inclusion in relevant Guidance Documents on the treatment of emphysema can be found by clicking the button below.
Zephyr Valve has Broad Coverage
More than 90% of patients nationwide are under policies with positive coverage or under plans that are not restricting access.*
- Medicare is covering patients who qualify
- >95% of patients with commercial insurance are securing coverage**
*Pulmonx data on file; assuming patients meet medical criteria for BLVR.
Zephyr Valves are approved by the Food and Drug Administration (FDA). Providers should contact their individual payers prior to performing the Zephyr Valve procedure for information on coverage.
The information is subject to change without notice because of complex and frequently changing laws, regulations, rules, and policies.
For reimbursement information, please visit: bit.ly/4aipqRI.
**Pulmonx Patient Reimbursement Support Program experience through the prior authorization process, for cases where patients opted in.
Patient Reimbursement Support Program
For patients who qualify for the procedure, the Pulmonx Patient Reimbursement Support Program is available to patients and their caregivers as they navigate the insurance process for the Zephyr Valve procedure. The program is staffed by case managers who are experienced in navigating through the payer maze. They will act as a dedicated advocate for any patient enrolled in the program and will work closely with the ordering physician office staff to ensure patient paperwork is complete, address billing and coding questions, and assist with any necessary appeals.
