Medicare pmts. for re-titration

[Portageegal]

Does anyone know how often medicare will pay for a re-titration? My AHI has been climbing and is now up to around 25. I don't have a leak problem and have tried all of your advice, so I need to find out what is going on.

[OwlCreekObserver]

I've been wondering about re-checks also. I was dragged kicking and screaming into Medicare a few months ago and I'm wondering if Medicare will allow my new facility to do a new sleep study so I can get an order from the new sleep doctor for a machine (when I need it) and (as it now appears from discussions here) masks, hoses, etc. I finally gave up trying to get anything out of my old DME, which apparently can't be bothered with mask or supplies requests. I've been paying out of pocket for masks and supplies elsewhere but I'd rather not do that for the rest of my life if I don't have to.

OCO

[Wulfman]

Does anyone know how often medicare will pay for a re-titration? My AHI has been climbing and is now up to around 25. I don't have a leak problem and have tried all of your advice, so I need to find out what is going on.

According to your profile, you have the S8 Vantage. How is it configured? (pressure settings, EPR, etc.)
Do you have the software or are you getting your numbers from the LCD?


Den

PS I read this thread and still have no idea about what pressure range or setting you are using.

viewtopic/t43361/viewtopic.php?t=40041

.

[Portageegal]

I've got a Res Med autoset II. I get the info from the LCD. I think it is set from 10-16 now. I have changed it from the original 6-14. My pressure usually averages around 11-13. I also hear myself snoring some nights.

[Slinky]

Was that original 6-14 setting after an unsuccessful in-lab titration?

[ozij]

Does anyone have the info about getting this new titration on medicare?

I think Portageegal needs one badly.

O.

[REK]

Hi,
I just had a re-titration study done last month, after being on CPAP for four years. When my sleep
doctor recommended that I have this done I asked about medicare coverage. I was told that
I could have a titration done once a year and medicare would cover it. I got my "explanation of
benefits" from them last week and they did cover it except for my 10 percent copay. I also
was able to get a new machine because the sleep lab reported that my old one was now
obselet, could not be repaired if it broke down, and my DME agreed.

[Portageegal]

Thanks, I guess I have to wait until fall to have a re-do.

[aherronrrt]

they normally cover a retitration if documented issues on current pressure. However if you are on a auto then you need to expand your pressure limits out to 20. You are prob. having hypopnea's and apnea on current settings. The auto will adjust as needed if you will expand the limits out to 4 - 20cmh20

[chunkyfrog]

Please note the date on the entire thread, nearly 5 years have passed.
I'm fairly certain the issue has been resolved by now
Why aren't you registered? It is easy, and anonymous, but you would have many more features available.

[nanwilson]

they normally cover a retitration if documented issues on current pressure. However if you are on a auto then you need to expand your pressure limits out to 20. You are prob. having hypopnea's and apnea on current settings. The auto will adjust as needed if you will expand the limits out to 4 - 20cmh20

Problem has long since been resolved... this is a 2009 thread And as a side if you are really an RT you will know that having the auto setting wide open 4 to 20 is not realistic as no one will get enough air at 4 and besides it takes way too long for the pressure to ramp up to catch apneas when you have it at too wide a range.