ResMed S9 Elite AutoSet vs straight CPAP

[Stevoreno_55]

I have an appointment with the doc next month and I plan to ask him to write me a Rx for a new CPAP machine with a HH. I'm hooked up with a new DME who so far I like but they only deal in ResMed machines. My pressure is 18cm; I'm currently using a Philips Respironics DS400S with C-Flex. My new RT has suggested an autoset(?) machine. What information has to be listed on a new Rx if I want to try to get a specific machine? If I want a ResMed S9 Elite with a HH set to a pressure of 18cm; will I have to stay with a machine like my current one which is set for straight CPAP? Do ResMed machines have a feature like C-Flex? What exactly is an autoset(?) machine and would I more than likely have to undergo a new sleep study to get one? Does an autoset have the same billable code as a regular straight CPAP machine?



Stevoreno_55
03/31/14

[zoocrewphoto]

I have an appointment with the doc next month and I plan to ask him to write me a Rx for a new CPAP machine with a HH. I'm hooked up with a new DME who so far I like but they only deal in ResMed machines. My pressure is 18cm; I'm currently using a Philips Respironics DS400S with C-Flex. My new RT has suggested an autoset(?) machine. What information has to be listed on a new Rx if I want to try to get a specific machine? If I want a ResMed S9 Elite with a HH set to a pressure of 18cm; will I have to stay with a machine like my current one which is set for straight CPAP? Do ResMed machines have a feature like C-Flex? What exactly is an autoset(?) machine and would I more than likely have to undergo a new sleep study to get one? Does an autoset have the same billable code as a regular straight CPAP machine?



Stevoreno_55
03/31/14

The Elite is a straight cpap machine is the Autoset is the auto version. Both have full data. Most DMEs want to see a prescribed range of pressure to get the auto machines, so a prescription of 16-20 would be helpful. If your doctor recommends the autoset, have him write the prescription for Resmed S9 Autoset with a range or pressures (you can change it yourself later, but I recommend NOT telling the DME that. Then dispense as written, so they have to give you the exact model. That is what mine did.

Do NOT accept any Resmed machine with the word "Escape". There is a regular and auto version, and neither one has full data. If they try to give you one of those, tell them the doctor wanted full data with leak info and events. This is why it helps to have the doctor write the exact model.

Resmed machines have EPR, which is their version of exhale pressure relief. It can be 1, 2, or 3 cm below the inhale pressure.

You may want to ask your doctor about a bipap machine as you do have a high pressure and that can give more relief.

[Guest]

at 18cm your dme should be recommending a bilevel machine
so should your doc
and you should be asking for a bilevel

and what are you doin posting @4:30 am you should be sleeping

[Tino2You]

What happened to my Avitar?


<edit> Wow it showed up this time

[STL Mark]

at 18cm your dme should be recommending a bilevel machine
so should your doc
and you should be asking for a bilevel

and what are you doin posting @4:30 am you should be sleeping

+1

My level is 18 and I found the S9 VPAP Auto to be a very comfortable machine to use. At your level I don't think you would have any problems from your insurance company.

[Tino2You]

The ResMed S9 Auto Set is an automatically adjusting CPAP machine. The machine senses when more air pressure is required, within a prescribed range" to keep the airway open. This is very useful if you are like me and require more pressure when you sleep on your back, versus side. The S9 Auto Set can be configured, as zoo pointed out, as a straight CPAP just like the S9 Elite. Like the Elite, it records full therapeutic data for later analysis (AHI, AHI duration, leak rate...) so you can track the effectiveness of your therapy. Both machines use the same billing code. The AutoSet is more expensive than the Elite which is more expensive than the Escapes. The Escapes (2 models, Escape and Escape Auto) are the cheapest and give the DME the greatest profit margin and IMHO the reason they push these "bricks" on unsuspecting patients. Neither of the Escapes records much in the way of therapeutic information but all ResMed machine records"AHIs" and "hours used per session" which some insurance companies require for compliance.

If it were me, (and it was a couple of years ago) I would ask my doctor to prescribe the AutoSet and set the range at 15 to 20. Also as Zoo pointed out, the straight CPAP (includes the AutoSet) have a max pressure of 20ml H2O. Beyond that you have to go to a BiPap,

hope this was helpful.

-tino

[Stevoreno_55]

at 18cm your dme should be recommending a bilevel machine
so should your doc
and you should be asking for a bilevel

and what are you doin posting @4:30 am you should be sleeping

Couldn't sleep!!!

[Stevoreno_55]

I have an appointment with the doc next month and I plan to ask him to write me a Rx for a new CPAP machine with a HH. I'm hooked up with a new DME who so far I like but they only deal in ResMed machines. My pressure is 18cm; I'm currently using a Philips Respironics DS400S with C-Flex. My new RT has suggested an autoset(?) machine. What information has to be listed on a new Rx if I want to try to get a specific machine? If I want a ResMed S9 Elite with a HH set to a pressure of 18cm; will I have to stay with a machine like my current one which is set for straight CPAP? Do ResMed machines have a feature like C-Flex? What exactly is an autoset(?) machine and would I more than likely have to undergo a new sleep study to get one? Does an autoset have the same billable code as a regular straight CPAP machine?



Stevoreno_55
03/31/14

The Elite is a straight cpap machine is the Autoset is the auto version. Both have full data. Most DMEs want to see a prescribed range of pressure to get the auto machines, so a prescription of 16-20 would be helpful. If your doctor recommends the autoset, have him write the prescription for Resmed S9 Autoset with a range or pressures (you can change it yourself later, but I recommend NOT telling the DME that. Then dispense as written, so they have to give you the exact model. That is what mine did.

Do NOT accept any Resmed machine with the word "Escape". There is a regular and auto version, and neither one has full data. If they try to give you one of those, tell them the doctor wanted full data with leak info and events. This is why it helps to have the doctor write the exact model.

Resmed machines have EPR, which is their version of exhale pressure relief. It can be 1, 2, or 3 cm below the inhale pressure.

You may want to ask your doctor about a bipap machine as you do have a high pressure and that can give more relief.

Will I have to undergo a new sleep study to qualify for a BIPAP? The RT with my new DME said I would not if I asked the doc to write me a new Rx for CPAP and then she said she would recommend an autoset(?) instead of a straight CPAP. If at all possible I would like to avoid another sleep study. My last study was back in October 2007; a 2-nighter and I would not like to have to go through that again; a bad facility which is now closed and that's all I'll say.

[Stevoreno_55]

I have an appointment with the doc next month and I plan to ask him to write me a Rx for a new CPAP machine with a HH. I'm hooked up with a new DME who so far I like but they only deal in ResMed machines. My pressure is 18cm; I'm currently using a Philips Respironics DS400S with C-Flex. My new RT has suggested an autoset(?) machine. What information has to be listed on a new Rx if I want to try to get a specific machine? If I want a ResMed S9 Elite with a HH set to a pressure of 18cm; will I have to stay with a machine like my current one which is set for straight CPAP? Do ResMed machines have a feature like C-Flex? What exactly is an autoset(?) machine and would I more than likely have to undergo a new sleep study to get one? Does an autoset have the same billable code as a regular straight CPAP machine?



Stevoreno_55
03/31/14

The Elite is a straight cpap machine is the Autoset is the auto version. Both have full data. Most DMEs want to see a prescribed range of pressure to get the auto machines, so a prescription of 16-20 would be helpful. If your doctor recommends the autoset, have him write the prescription for Resmed S9 Autoset with a range or pressures (you can change it yourself later, but I recommend NOT telling the DME that. Then dispense as written, so they have to give you the exact model. That is what mine did.

Do NOT accept any Resmed machine with the word "Escape". There is a regular and auto version, and neither one has full data. If they try to give you one of those, tell them the doctor wanted full data with leak info and events. This is why it helps to have the doctor write the exact model.

Resmed machines have EPR, which is their version of exhale pressure relief. It can be 1, 2, or 3 cm below the inhale pressure.

You may want to ask your doctor about a bipap machine as you do have a high pressure and that can give more relief.

Has there ever been a case to the best of your knowledge where a DME would try and issue a "used" machine to a patient and claim that their "used" machine was a brand "new" machine? Once a machine has been issued to the patient can the patient contact the manufacturer; in this case ResMed since we're discussing ResMed machines and ask ResMed if the machine the patient has just received from their DME is a "new" machine or a very thoroughly cleaned "used" machine? Just curious.

[Stevoreno_55]

at 18cm your dme should be recommending a bilevel machine
so should your doc
and you should be asking for a bilevel

and what are you doin posting @4:30 am you should be sleeping

+1

My level is 18 and I found the S9 VPAP Auto to be a very comfortable machine to use. At your level I don't think you would have any problems from your insurance company.

You don't think I would have any problems from my insurance company trying to get a BIPAP machine or continuing my therapy at 18cm on a straight CPAP machine; a ResMed S9 Elite CPAP machine with HH and not attempt to get an autoset(?) machine? My gut feeling tells me I'd probably have to undergo a new study to qualify for a BIPAP as well as an autoset(?) machine since someone else has previously stated here with an autoset(?) machine order my doctor would have to list a pressure range on his Rx. My doctor is my PCP; he is not a "sleep doctor".

[Pugsy]

You might need another sleep study to get a bipap machine...depends on your insurance.

You shouldn't need a new sleep study to get an APAP machine like the S9 AutoSet instead of a S9 Elite.
The billing codes for both machines are the same and insurance companies just pay by billing codes. If your insurance will pay for a new S9 Elite...they will pay for the S9 Autoset.
Now DMEs might tell you that the insurance won't ....but that's not true...insurance companies don't care if the machine is an Elite or AutoSet....same billing code E0601...they just make more money selling the Elite and that's why they don't want to sell the AutosSet.

Now the bipap...that's a different billing code but insurance might be happy with the doctor just saying that because of high pressure needs the bilevel pressure machine is needed. It's done all the time...just needs some extra documentation from the doctor.