APAP vs. Aerophagia. Proof?

coffee · Post by **coffee** » Tue Apr 12, 2005 9:27 am

The ins. co. denied the request.
I think the problem is that they have already given me a machine(CPAP) and do not see the need to give me another. If my appeal fails, then I will either have to pay for it myself now, or wait until february 23, 2006 when my CPAP machine will be 5 years old and I become eligible for a replacement. Then I can try the billing code method and hope they will authorize the DME to provide an APAP instead of a CPAP. But right now my effort to get an APAP is based on the conviction that the APAP will provide me with the tolerable treatment that CPAP is not providing.
In other words, they will not authorize a replacement machine unless I can convince them it is a medical necessity to have an APAP instead of the CPAP they already gave me.