Bi level machine with 30 cwp

[danielz]

Hi, I'm new to all of this so please forgive any errors or ignorance in my questions.

My prescription that I just received is: ipap 27, epap 23, ti min 1.0 sec, ti max 2.0 sec, rise 500 msec, trigger medium, cycle medium.

My doctor originally prescribed an S9 machine. I was told an S9 VPAP-S, though that doesn't turn out to be the case. I asked about the newer generation machines and she put in a prescription for a aircurve. The DME came back and said it wouldn't have high enough pressure. I said okay. I started to make my appt with the DME. When I asked which machine they were providing, they said S9 COPD, which when I look does go up to 30 cwp.

Does this make sense? Are there any Aircurve machines with 30 cwp (there weren't any that were obvious to me, though I'm a little lost in all the different models)? Should I be asking further questions? Thank you for any help you can provide.

[Pugsy]

I don't see the COPD model in the new AirCurve model line
http://www.resmed.com/us/en/consumer/pr ... vices.html
I think the max on the other Aircurve machines is 25.

[Maniac007]

Look for the AirCurve 10 ST-A.It says for severe COPD. I looked but didn't see anything on pressures.

[JDS74]

ResMed Aircurve10 vauto ST fits the prescription parameters.
Max pressure is 30 cm H2O.

http://www.vitalitymedical.com/pdf/airc ... -guide.pdf

Edited to correct the machine name and link to manual.

[danielz]

Thanks for all the suggestions.

The ST-A does seem to go up to 30 if I'm understanding things correctly. p20 of http://www.resmed.com/us/dam/documents/ ... er_eng.pdf

Whereas the Auto, S, ST seem to only go to 25. p 17 of http://sleeptech.ca/wp-content/uploads/ ... er_eng.pdf

Will the ST-A do what I need for my prescription? The fact that it (and the S9 COPD) are for COPD is incidental, right? They work for me because of the high pressures on my prescription? (Though I suppose the fact that they work up to 30 could have something to do with COPD, which I don't understand.)

[palerider]

ResMed Aircurve vauto S-T fits the prescription parameters.
Max pressure is 30 cm H2O.

stick to the things you know about... ie, not resmed, please.

there's no such thing as an 'aircurve vauto s-t"

there's a aircurve10 vauto and an aircurve10 ST, neither of which go to 30cm pressure.

the only resmed machines that go to 30cm are the s9 vpap COPD, the s9 vpap ST-A, and the aircurve10 ST-A

[danielz]

Is there something significant I would get from the aircurve 10 st-a that I wouldn't from the s9 copd? Is the aircurve 10 st-a a lot more expensive (I couldn't find a price online), so that it would be a big fight to get it?

[palerider]

Is there something significant I would get from the aircurve 10 st-a that I wouldn't from the s9 copd? Is the aircurve 10 st-a a lot more expensive (I couldn't find a price online), so that it would be a big fight to get it?

the COPD is targeted at... COPD.

the ST-A is more of a swiss army knife machine, for more uncommon problems, though copd is one of the things it's good for.

[Guest]

Is the aircurve 10 st-a a lot more expensive (I couldn't find a price online), so that it would be a big fight to get it?

I am willing to bet it is.

[Pugsy]

The AirCurve 10 ST-A is going to be quite a bit more expensive (all the sites I saw wouldn't even list a price which usually means really high dollar) because it does a lot of other stuff targeted for people with various respiratory issues than the S9 COPD model does.
The ST-A will do a lot of stuff that you won't be needing.
Sounds like if the regular AirCurve 10 models would go to 30 they would also work but since they only go to 25 and you need more they won't work. Doesn't sound like you need anything special other than higher pressures.

Here's the thing though...there are only 3 HCPCS billing codes out there for xpap use.
Your insurance (assuming you have insurance) will be using the E0471 for your machine because the E0470 bilevel machines won't go to 30 cm. You have to use a machine with the E0471 coding...and insurance pays by code and not model number/name.
Insurance is going to pay the same whether you get the S9 COPD model or the AirCurve 10 ST-A model. DMEs will be getting the same amount of money no matter the model but they will want to dispense the model that costs them less in order to maximize their profit.

Code: Select all

CPAP/BiPAP MACHINE INSURANCE (HCPCS) CODES
E0601 	Continuous airway pressure (CPAP/APAP) device
E0470 	Respiratory assist device, bi-level pressure (BiPAP) capability, WITHOUT backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)
E0471 	Respiratory assist device, bi-level pressure (BiPAP) capability, WITH backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)

There is a 4th code but that machine is used with invasive ventilation...like true ventilators with a tracheostomy

I am reasonably certain that the S9 COPD machine falls under the E0471 HCPCS code. If anyone knows differently please speak up.

Now if you don't have insurance coverage...by all means get the least expensive machine that will get the job done.

[palerider]

The AirCurve 10 ST-A is going to be quite a bit more expensive (all the sites I saw wouldn't even list a price which usually means really high dollar) because it does a lot of other stuff targeted for people with various respiratory issues than the S9 COPD model does.
The ST-A will do a lot of stuff that you won't be needing.
Sounds like if the regular AirCurve 10 models would go to 30 they would also work but since they only go to 25 and you need more they won't work. Doesn't sound like you need anything special other than higher pressures.

Here's the thing though...there are only 3 HCPCS billing codes out there for xpap use.
Your insurance (assuming you have insurance) will be using the E0471 for your machine because the E0470 bilevel machines won't go to 30 cm. You have to use a machine with the E0471 coding...and insurance pays by code and not model number/name.
Insurance is going to pay the same whether you get the S9 COPD model or the AirCurve 10 ST-A model. DMEs will be getting the same amount of money no matter the model but they will want to dispense the model that costs them less in order to maximize their profit.
... I am reasonably certain that the S9 COPD machine falls under the E0471 HCPCS code. If anyone knows differently please speak up.

Now if you don't have insurance coverage...by all means get the least expensive machine that will get the job done.

*waves hands* the COPD should be under E0470, not E0471, the COPD doesn't have a backup rate, but the ST-A does.

the S9 COPD is a vpap S with default settings that are better for COPD, an alarm module, and a limit of 30 instead of 25, but the settings available on it are the same (except for the max ipap) as the S.

[palerider]

Hi, I'm new to all of this so please forgive any errors or ignorance in my questions.

My prescription that I just received is: ipap 27, epap 23, ti min 1.0 sec, ti max 2.0 sec, rise 500 msec, trigger medium, cycle medium.

interesting, and by interesting, I mean strange, prescription.

the S9 COPD defaults are TiMin 0.3, TiMax 1, rise 150ms, trigger med, cycle high.

as I understand it, with COPD it's harder to exhale, so the default settings give you a short inhalation, sensitive to the end of your inhalation, and lots of time to exhale.

your rx.... not so much.

[Pugsy]

*waves hands* the COPD should be under E0470, not E0471, the COPD doesn't have a backup rate, but the ST-A does.

Okay...I was wondering about that part. I couldn't find a S9 COPD spec that mentioned backup rate or not.
That's why I ask if anyone else knew the billing code.
I got the AirCurve ST-A manual but didn't get the S9 COPD manual.
So never mind what I said about billing codes.
It doesn't look like ResMed is making an AirCurve 10 COPD model at least yet...since the ST-A can be configured to do the job when COPD is involved.
Thanks for the correction. I wasn't real sure I was on the right track

[palerider]

*waves hands* the COPD should be under E0470, not E0471, the COPD doesn't have a backup rate, but the ST-A does.

Okay...I was wondering about that part. I couldn't find a S9 COPD spec that mentioned backup rate or not.
That's why I ask if anyone else knew the billing code.
I got the AirCurve ST-A manual but didn't get the S9 COPD manual.
So never mind what I said about billing codes.
It doesn't look like ResMed is making an AirCurve 10 COPD model at least yet...since the ST-A can be configured to do the job when COPD is involved.
Thanks for the correction. I wasn't real sure I was on the right track

I can send you a copy of the clinician manual if you'd like

[Pugsy]

I can send you a copy of the clinician manual if you'd like

No need. Just more stuff for me to lose. I believe you.
What was so irritating to me was when I would go to websites that sell the AirCurve ST-A and tried to confirm it went to 30...the damn websites I found showed 25 max. That's when I decided to get the manual from the apneaboard to see the specs.
I already knew the S9 COPD went to 30 but didn't know for sure about the backup rate thing.