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Medicare TReatment/Diagnosis Codes
#1
Medicare TReatment/Diagnosis Codes
Having an issue with our DME and billing in regard to Medicare. My wife was on a Dreamstation AutoSV which her doctor said wasn't working for her. In fact, it was making things worse. She was then prescribed a ResMed Aircurve 10ST and she has seen some positive results with that. Even though she has had the Aircurve for about 10 months we just got a bill from the DME as they said Medicare denied the claim. It had been approved way  back when, but now they are saying it hasn't.

I am looking to see if anyone has the codes for the Dreamstation AutoSV and the ResMed AirCurve 10 ST.

I am trying to lay some of the groundwork so I can talk to my wife's sleep doctor and get this resolved. On top of it, her sleep doc left the practice she was with and formed her own and we are in the process of trying to get her records from the prior practice where she was when the second machine was prescribed.The good news is the DME has marked the bill as being contested so the clock isn't running.

TIA
Homer

Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies. Monitors are also Advisory Members, just with Extra Work assigned.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#2
RE: Medicare TReatment/Diagnosis Codes
http://www.apneaboard.com/wiki/index.php...S.29_CODES:

CPAP/BiPAP MACHINE INSURANCE (HCPCS) CODES:[edit]

E0601 Continuous airway pressure (CPAP/APAP) device  
E0470 Respiratory assist device, bi-level pressure (BiPAP) capability, WITHOUT backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)  (VAuto, S)
E0471 Respiratory assist device, bi-level pressure (BiPAP) capability, WITH backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) (ST, T, ASV, iVAPS)
E0472 Respiratory assist device, bi-level pressure (BiPAP) capability, WITH backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)
E0561 Humidifier, non-heated, used with positive airway pressure (CPAP/BiPAP/APAP) device
E0562 Humidifier, heated, used with positive airway pressure (CPAP/BiPAP/APAP) device
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#3
RE: Medicare TReatment/Diagnosis Codes
Thank you. I did run a search on codes, but got nowhere.
Homer

Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies. Monitors are also Advisory Members, just with Extra Work assigned.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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