Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

need CPP or CPT code for resmed aircurve 10 ASV with oxymiter
#1
Got the Rx from my doctor for an ASV
diagnosis G47.33 & G47.31
Also got write up saying bipap was a fail and that I need the ASV

My Insurance says it is covered
My insurance has NO 4 hour a night requirement or anything except doctor saying it is necessary, and maybe also appropriate

But my insurance  need some CPP code to approve the device
That is what I heard but it might be a CPT code 

The old bipap code was E0470 or E0471

How can I find the code for the resmed aircurve 10 ASV hopefully with oxymeter as that is the only data I care about

Insurance was told by sleep lab that another study is needed
It took 6 months to get the last one done to get the bipap machine that failed

I do not want to spend the money or wait 3+ more months again

Couldn't the DME provide the code?
Isn't there a list that I can see the code and tell my insurance ?

So, where is there a list of CPT codes that match up to machines that I can use to identify the device ?


------------
UPDATE

Searching found this
http://www.resmed.com/us/dam/documents/ ... elines.pdf
scroll down to complex apnea

It appears the CPT code for all apneas is E0470 and E0471

unless there is a reason that is not at all clear to do another sleep study
that code should be all my insurance needs.
#2
is this what you need?

http://cdn2.hubspot.net/hub/299691/file-...IDE_AND_CO

Current Procedural Terminology (CPT) is a medical code set that is used to report medical, surgical, and diagnostic procedures and services to entities such as physicians, health insurance companies and accreditation organizations
#3
If it's the HCPCS code for a non-invasive ASV, then it's E0466.
A CPT code is a Current Procedure Terminology code.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.


#4
Maybe
I will check the link


I am not sure the nice lady at the insurance really knows what I need.
She said CPT code.
I found this
http://www.resmed.com/us/dam/documents/ ... elines.pdf
which for complex apnea still has E0470 and E0471

I think she is getting confused over ICD CPT and manufacturer and device codes and maybe HCPCS code too


I need an ASV
The doctor wrote ASV on the Rx
He gave documentation to justify ASV


I am not sure why the insurance people wanted another code as I still have apnea only need the correct machine to treat CSA
they had the apnea codes from the failed bipap already
#5
Thanks

that differs from the code on the chart at the resmed site
http://www.resmed.com/us/dam/documents/ ... elines.pdf
scroll down to complex apnea and codes are still E0470 and E0471 

Where did you find the E0466 code ?
That code was not on any of the links posted here .
#6
I answered this in your other thread. It is a HCPCS code E0471 for non-invasive BiPAP with backup rate.


#7
Thanks

That chart does not have an E0466 listed
And it seems to disagree with the resmed chart codes. 

I need a code for a new ASV that was on the Rx
I would prefer it have an oxymeter added 
the Resmed aircurve 10 ASV with oxymeter is what I would like to get
using any code that insurance will accept 

Where did you find the E0466 code?

the insurance lady said CPT code which seems to be a subset of the chart you pointed to.
#8
(04-24-2017, 03:41 PM)Sleeprider Wrote: I answered this in your other thread. It is a HCPCS code E0471 for non-invasive BiPAP with backup rate.

I have seen several answers.
I did not see your E0471 but that agrees with the resmed chart.

However, bipap was a total fail and I have an Rx for an ASV machine.

One person pointed to a chart and said it was E0466 but that number was not on the chart.

So the question is where can I find a list that would include the code for ASV .
I agree that resmed said complex was E0470 and E0471 which the ASV would be the device that should be prescribed as the doctor did. 
The Rx specifically said ASV but the insurance lady wants a code to match to that device.
#9
I found the HCPCS code E0466 at a site Findacode.
At that site, I searched for "Adaptive Servo Ventilator". There were several results.
I picked the one that was for use with a mask.
It's possibly incorrect; or, sometimes one HCPCS covers several machines. Like the code for a CPAP is the same as for a Auto PAP.

If they want the CPT code, then they want the code of an ASV titration.
They may decline to dispense without titration.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.


#10
May I ask an obvious question here?

What insurance company, whether it be Medicare or any other insurance, doesn't already have the insurance codes needed for billing purposes?

Not to mention, if you are buying through a DME, they are the ones that bill insurance with the proper code.

The customer doesn't normally get involved with billing, (unless done incorrectly).

Now I'm not saying you shouldn't be informed and know the billing codes, but you shouldn't have to do their job for them.  

Just my 2 cents.
OpalRose
Apnea Board Moderator
www.ApneaBoard.com

How to Organize and Post ScreenShots

http://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.






Possibly Related Threads...
Thread Author Replies Views Last Post
  [Pressure] Help with optimal settings on my ResMed AirCurve 10 VAUTO (using Swift LT Nasal Pilw) TimmyT 6 49 7 hours ago
Last Post: trish6hundred
  [Pressure] Help w ResMed Aircurve 10 Vauto Settings BlueJay22 18 281 8 hours ago
Last Post: BlueJay22
  [Equipment] ResMed AirCurve 10 VAUTO Aknakon 7 382 08-06-2017, 04:01 PM
Last Post: Aknakon
  First night results aircurve 10 ASV mike.winslow 26 680 07-28-2017, 01:24 AM
Last Post: DeepBreathing
  Aircurve 10 CS Pavewave showing no CAs ThrownOutTheAsylum 9 222 07-26-2017, 10:15 AM
Last Post: ajack
  [CPAP] trigger setting for ResMed aircurve 10 vauto dwbenziger 5 250 07-25-2017, 04:12 PM
Last Post: Sleeprider
  Phillips Auto Bipap vs. Aircurve 10 Vauto? William Dunn 4 249 07-15-2017, 01:33 PM
Last Post: William Dunn

Forum Jump:

New Posts   Today's Posts




About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.

For any more information, please use our contact form.