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PCP Visit
#1
I had a check up with a new PCP (Personal Care Physician).  In reviewing my charts, the doctor noticed I had been on PAP therapy for 8 years with no follow up.  I've lost 70 lbs since the original diagnosis.   The doctor said, "Maybe you don't have a need for your machine any longer as you've lost a lot of weight."  I said, "I still need it."  Doc said, "How do you know."  I said, "Quit using it for a few days..."  Doc pondered, "Maybe it needs new settings."  I replied, "It's automatic adjustment."  Next issues...

I'm pondering if getting a new machine under Medicare is going to cause me more hassles.  Presently, I split my time in two places and have a machine at each...
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#2
Medicare allows a new machine every two years but I strongly doubt they will approve 2 even if ordered by your Dr.  If you get a ResMed Airsense 10 Autoset, you will find it's relatively small and light. I find it easy to travel with. If you fly you can carry it on and it doesn't count against your two item limit.  The padded case provides goo protection.

I have no idea what kind of data your machine supplies. If you can see your AHI values you should post some here.

If it has an SD card you may be able to use SleepyHead software and post data in the forum to get help with settings.

I'm assuming your machine is 8 years old. If that's the case, you should be able to get a new machine under Medicare coverage. Be sure to insist on a data capable autoset machine. The consensus in the forum seems to be that  the ResMed AirSense 10 Autoset is the best.

See my signature line for information on SleepyHead

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#3
I think under medicare if you have not had regular follow ups with your
Dr. at least once a year and had a very recent visit to your DR. you will
need a new sleep study.  I just went through this with my DME and my Dr.
And the rule about replacing a cpap is sort of hazy. Technically it's not supposed
to be replaced till it's broken and non repairable or the Dr. says you need a 
different type.  But I think at about 5 years most DME's just say yours is
bad and not repairable.
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#4
from: http://www.resmed.com/us/dam/documents/a...achine.pdf

"More than five years
The replacement of an item past the five-year lifetime will
be considered in cases of irreparable wear if the item has
been in continuous use by the patient, on either a rental
or purchase basis, for the equipment’s useful lifetime.
• Irreparable wear:
– Irreparable wear refers to deterioration sustained
from day-to-day usage over time and a specific
event cannot be identified.
– In cases involving irreparable wear, the Reasonable
Useful Lifetime (RUL) of the equipment is taken into
consideration, and in no case can it be less than
five years old.
– Computation of the useful lifetime is based on when
the equipment is delivered to the patient, not the
age of the equipment.

A physician’s written order is needed to reaffirm
the medical necessity of the item.
• If a PAP machine is replaced following the five-year RUL,
there must be a face-to-face evaluation by the treating
physician documenting that the patient continues to
use and benefit from the PAP machine. There is no
requirement for a new sleep test or trial period.
Note:
If a DME item reaches its five-year life expectancy, is
in good working order and meets the patient’s medical
needs, it should not automatically be replaced."

Admin Note:
JustMongo passed away in August 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#5
I had the same discussion with my sleep doc as I had lost 125lbs and wasn't sure I needed it any longer. Did a trial without and had another sleep study done and do still need CPAP. Although you have an "auto" machine the range can be adjusted to meet your needs. My pressures have changed dramatically though. was originally at 15/10 now at 9/7 and am working to get it dialed in just right. I am on my second machine, ResMed AirSense 10, and love that I can see my own results in Sleepy Head.
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#6
(03-16-2017, 02:11 PM)Melman Wrote: Medicare allows a new machine every two years b

How embarrassing, I didn't review my post very well. I meant to say 5 years, not 2years.

JustMongo, thanks for correcting my erroe.

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#7
That's so strange to me. Was your dr trying to steer you away from CPAP or allude that you don't have apnea anymore simply due to weight loss? Or was he simply bringing up a subject that was worth exploring? (I'm just curious.)
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#8
My PCP has changed, as my previous is in another facility. In the initial check up, the PCP was just making inquiry about my health, which I appreciated. One Rx was eliminated and another changed.
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#9
Ah, ok.
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