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Medicare and 2nd machine
#21
(05-24-2015, 12:05 PM)multime Wrote:
(05-24-2015, 11:19 AM)krelvin Wrote: Can you please provide citations for your statement please?
(05-24-2015, 02:51 AM)multime Wrote: Citation

Please read the hoses section. Also this is very common knowledge and as such before asking others to provide citations you should spend the one minute it takes with a Google search.
Actually was looking for medical citation. Not a link to a website with no citations on their information as well.

The fact is the best chance for mold would perhaps be in the tank itself, But the chance for mold is non-existent if you use Distilled water and dump the left over water out regularly.

If you happen to live in a very humid area, then of course you need to adjust what you are doing, not only related to CPAP use, but much of you living surfaces. That is something most don't need to deal with.

Your original post said infection concerns. That would tend to be related to catching a cold or the flu, but unless you are sharing your equipment with other people, the only "germs" on your equipment is from you.

If you have mold on any parts of your CPAP parts, you don't clean it you replace it.

If you have some immune deficiency issue, you should be under constant care as you have many other things to worry about.

Circular Reference...
Quote:Sue told me that I shouldn't do that. Where did Sue get that information, Oh, she got it from Henry. Where did Henry get that from? He got it from Sue.
Current Settings PS 4.0 over 10.6-18.0 (cmH2O) BiLevel Auto
TNET Sleep Resource Pages
CPAP Machine Database
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#22
(05-24-2015, 01:43 PM)krelvin Wrote: .......Your original post said infection concerns. That would tend to be related to catching a cold or the flu, but unless you are sharing your equipment with other people, the only "germs" on your equipment is from you. .......

You may be forgetting about airborne bacteria and viruses. Unless one has a bacterial filter, airborne pathogens are a possibility. The problem can be that the mask and hose may provide an accumulation area for pathogens.

There was a study done by someone that found a geometrically accelerated pathogen level in masks over time. I do not remember who did the study so can not provide a citation for you.

With all of that said I am not overly concerned about pathogens in my mask or hose. I wash them when I get a round tuit and I have only changed masks to solve leak or other problems.

Best Regards,

PaytonA
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#23
When I said infection concerns I was referring to things like sinus infections, colds, bacteria etc. No matter how well you clean your hoses you can still get bacteria to build up in the middle of the hose between the ridges. This accumulates over a period of time.

Also keep in mind that the medical community and insurance companies base their policies on what the masses will do. So for example the masses will 'not' clean their tubes as thoroughly as say an ocd germaphobe.

So the risk of infection might be low if cleaned fully but insurance knows this won't occur so they endorse replacement.

People know that if they go out to party they will get drunk but how many times do they take actions to prevent them from driving drunk. People don't even stop this when death and/or jail is on the line. Our hardware risk is mostly just minor infections not death or jail as a deterrent.

This is just my two cents worth. Oh and for simple and obvious topics I won't be providing citations. I'm not taking college composition on an internet forum. This is more of a civil court setting where we base our statements on whether the evidence is more likely than not to be accurate. This isn't beyond all doubt where citations are needed.

If you 'want' citations I'd suggest you get them yourself. You won't get many people willing to help you if they feel their reply will demand a citation. This is why I won't be answering your posts from this point on. I've spent far too much time on this as it is. I don't intend to waste more time.

Sorry for being blunt and harsh. Edit..please don't waste your time forming any reply towards me Krevlin as I've placed you on my ignore list for the time being. This is to prevent any back and forth feud that always seems to follow me.
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#24
(05-24-2015, 02:51 AM)multime Wrote:
(05-24-2015, 12:24 AM)Jim Bronson Wrote:
(03-16-2015, 06:32 PM)Mike1953 Wrote: Medicare may allow a new machine every 5 years but each time a new machine is issued you have to show the compliance and meet face to face with your Dr. who has to file that it is a benefit to your health. Then you have to meet with him within the 90 days compliance for Medicare to continue to pay for your new machine. Compliance is at least 4 hours each night for 70% of the time during the first 90 days of using a new machine.
Medicare and most private insurers cover scheduled replacements of all mask parts and other supplies (including CPAP machines, but we’ll talk about those in an upcoming blog post). Ask your insurance provider how often it will cover the replacement of each part. Your equipment supplier can answer any questions about this and even help you fill out and process any necessary forms. Based on Medicare coverage, we suggest that you replace:
Every month
• Mask cushions and/or nasal pillows
• CPAP machine filters
Every 3 months
• Mask frame (not including the headgear)
• CPAP tubing
Every 6 months
• Mask headgear
• Chin strap (if applicable)
• Humidifier water tub
IMO, there's no reason to replace all the above items as frequently as Medicare allows. Examples:
Mask cushions: I've been using the same mask cushion for three months, and it is good as new. At the rate the DME is sending them to me, I'll need a new closet to store them all.
Filters: The replacement frequency depends on the environment, but the filters are cleanable and reusable. I have about 20 now, and I'm still using the original one.
Mask frame: Mine is just a piece of plastic. Unless it somehow gets damaged, it will last for years.
Tubing: Cleanable and reusable. It should last for years.
Headgear: I agree with this one. The velcro does lose its adhesion after a while and the elastic can get brittle.
Chin strap: Ditto - the elastic can get brittle after a few months.
Humidifier water tub: There's nothing to wear out. It is just a plastic container with a hinged lid. Should last for years.

When it comes time for the next three month supply cycle, I'm going to tell my DME what I need, and tell them not to send anything else. There's enough Medicare fraud without me adding to it.

These items are usually replaced this often because of infection concerns. Bacteria have ways of sneaking into worn or old items even if you clean them.

Just don't discount this risk.
Bacteria form on the mask after you open the package, assuming it was packaged in a sterile environment. Bacteria form before the first use. It is present in the water you wash it with and the air you dry it with. It is present in your toothbrush and the coffee cup you rinse out after you use it. It is everywhere except perhaps in operating rooms and NASA clean rooms. Our immune system is quite capable of dealing with most harmful bacteria most of the time, except in individuals with compromised immune systems ("Bubble Boy" in the extreme case).

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#25
If you do not want to get a cold, stay away from people. You can get a cold from anything touched by a person who has a cold: your door knob, your pencil, your phone, desk, spoon, table cloth, or anything else. People who are afraid to get colds should never shake hands with anyone.

Not sure why you would let someone else touch your mask, stick their fingers into your hose and humidity tank. I certainly wouldn't.

You can't catch a cold from yourself since your immune system knows how to defeat that variation. You won't get that version of the cold again. You catch new colds because they have evolved to the point you immune system doesn't recognize it.
Current Settings PS 4.0 over 10.6-18.0 (cmH2O) BiLevel Auto
TNET Sleep Resource Pages
CPAP Machine Database
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#26
Mike1953-
My understanding of Medicare Compliance is that one can take any 30-day 'block' of time during the first 90 days of use, and 70%, or 21 of those 30 days must result in CPAP use of at least 4 hours a day. So, it's not the 90 day period in which to comply that use of 4 hours a day must be 70% (63) of those 90 days.

My DME contacted me on my 30th day of use. Since my usage was 70% or greater, they sent the info on to Medicare Compliance and I haven't had to further provide evidence of compliance.
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#27
See below
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#28
Actually, krelvin has a good point. We're going for "clean" not "sterile" components. I've been using since 11/2013 with no evidence of "infection concerns".

Your mouth and other organs has more bacteria than the xPAP equipment.

Sheesh.
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#29
I have to agree with Multime. Insurance procedures are built on an "on average" bottom line. You can bet money that thay are serving their bottom line. They have learned over time that the masses do not clean or protect their machines and accessories and that this behavior causes them more complications and cost than just supplying the replacement parts. Those of us on this forum have greater than average concern for our therapy and are willing to educate ourselves and put forth some effort in maintaining our equipment. The majority of XPAP users are not as consciencous. Their pets lick and chew their headgear, masks and hoses. They never clean their hoses and humidifiers and use tap water; the resulting moisture with mold and bacteria collect and multiply in their chewed and cracked hoses. The hard water deposits from the tap water in their humidifiers build up and degrade performance. I could go on...yada, yada
If you don't need accessories at the allowed rate, don't order them.
if you can't decide then you don't have enough data.
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#30
I like to have 1 or 2 backups for each component I use. Since I switch between several masks randomly I like to have backup parts for each and a couple backup heated hoses. Once I am stocked I only order replacements as required.
Now if they would only provide a backup ASV machine I would be all set.
As to compliance I don't remember any insurance request or requirements for compliance in the 4.5 years I have been a hose head.
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