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[Diagnosis] Central Sleep Apnea newbie
#31
Are you guys sure the Bipap is good for central?? I'm not up on all the machines, but I thought the ASV machines were the one's to use.

OK, it looks like this can be like a "ventilator", so it should be ok. Sure hope it works out!!!
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#32
Yeah the Bipap ST is also used for Central. That's what I've been finding in my research. Although i would feel better if he was prescribed the adapt or avs. I will definitely make sure he can swap out machines if this one doesn't work well. Smile
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#33
The BiPAP/VPAP S/T IS used for central apnea.

In my opinion, it's almost always better to get a real ASV machine for central, but I can't say the S/T is absolutely "wrong."

I suspect someone is choosing the device based on money, not what's best for the patient, or because they're not really up to date on the newer machines. Hopefully, you have the option of switching to ASV later if needed without having too much of an insurance hassle.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#34
(12-19-2014, 12:53 AM)archangle Wrote: The BiPAP/VPAP S/T IS used for central
I suspect someone is choosing the device based on money, not what's best for the patient, or because they're not really up to date on the newer machines.


I don't understand why they wouldn't do the ASV because my husband's insurance is paying at 100% right now. I would have insisted on ASV, but with the rush to get everything done before January 1st and getting to the sleep study only to find they are only trying the S/T on him...well we ran out of if time. For them to switch him to ASV it would require another sleep study, right?

I am really hoping for the best. It's all I can do at this point. :/
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#35
(12-19-2014, 11:14 AM)amnesiachick Wrote: For them to switch him to ASV it would require another sleep study, right?

I am really hoping for the best. It's all I can do at this point. :/

There's a good chance S/T mode will work for him.

It is not given to man to understand the ways of insurance companies.

Hard to say whether insurance will require a separate ASV titration or not. The doctor can write a prescription for ASV without a new study. The machine itself would tell him if it's working, and it can be monitored and adjusted remotely with the cellular modem. The medical mafia tends to love doing another $leep te$t before doing so, so a lot of doctors won't take the time or effort to do it without a separate titration.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#36
Thanks. Hoping for the best.
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#37
I *can* tell you that 'Medicare' *does* require a titration to go from CPAP to VPAP to ASV - any of the big steps requires a separate titration. I was on a VPAP (bilevel) for many years, but Medicare would only give me a CPAP as I had not been titrated for bi-level. So then we went ahead and got me titrated for ASV and now life is better - it's been bout 4-6 weeks now, and it looks like I must have back-slid some, as all of a sudden (as of 3 days ago) I am sleeping a bit less per night than in the last year or so (like 1-3hrs less) - which is very nice.
*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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#38
(12-20-2014, 10:41 PM)archangle Wrote: Hard to say whether insurance will require a separate ASV titration or not. The doctor can write a prescription for ASV without a new study. The machine itself would tell him if it's working, and it can be monitored and adjusted remotely with the cellular modem. The medical mafia tends to love doing another $leep te$t before doing so, so a lot of doctors won't take the time or effort to do it without a separate titration.

Hi amnesiachick,

The insurance code for purchase of an S/T machine and for purchase of an ASV machine is the same code (HCPCS Insurance Code E0471 NU). Both are classified as a Bi-level machine with Backup respiration rate: "Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)"

So I suggest pointing out to your doctor that both machines are classified the same for insurance purposes, and asking your doctor to write the prescription for the machine of your choice.

ResMed A10: AirCurve 10 ASV with heated hose, and mask of patient's choice
ResMed S9: S9 VPAP Adapt (REF# 36067 if in USA, I think) plus humidifier and heated hose, and mask of patient's choice

Philips Respironics: DS960TS (BiPAP autoSV Advanced with heated hose) and mask of patient's choice.

For insurance purposes, the expense needs to be "incurred" before the end of the year. I think this means billed by the end of the year. I think the machine can be billed as soon as it is delivered or when shipped to you.

Your insurance network probably has more than one Durable Medical Equipment (DME) provider in it. Get a list of DMEs who are in your insurance network and call around to find one who has the machine you want, or who can get it and deliver it to you (or at least ship and bill) before the end of the year.

Good luck and take care,
--- Vaughn


Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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