Being Forced to use a Reconditioned Machine

[ProfessorEd]

Thanks.

My instinct, like yours, is if I am upgrading to try to have the best, especially when someone else is paying for most of it (Medicare). The usual situation is that more costs more, and you worry about the salesman pushing more on you than you need or would want to pay for (think buying a new car or house). The peculiar economics here is that the seller is hurt if you get more (I think) so they don't even tell you often, what the options are, or try actively to keep you from getting them.

[chunkyfrog]

With insurance, as well as Medicare, YOUR money was paid into the program as premiums or a payroll tax;
so "someone else" is NOT paying--YOU are.

[ProfessorEd]

From what you know (Medicare and Cigna insurance, current Respionics Bipap auto user) is the Respironics PR System One 60 series BiPap Auto with BiFlex along with the heated tube equipment probably the best to ask the doctor to prescribe? I think this is their latest and best model, but I may have missed something. I do not not travel much and appearance and quietness are secondary to good treatment, and access to data to improve.

Y

Talking to the doctor's assistant, he apparently wrote the prescription in term of billing codes for Medicare, with one apparently for a heated humidifier tube (or possibly just a heated humidifier, when I think about it). Does anyone know what relevant codes are, and how tightly they constrain the DME? I am having a copy mailed to me.

[Pugsy]

I have the codes and allowable amounts from last year. Haven't seen this years yet.

For Bilevel machines (these are typically a rent to own thing for 13 months)
http://www.resmed.com/us/documents/1013 ... et_rad.pdf

General supplies and humidifier (these are a purchase up front...no rent to own)
http://www.resmed.com/us/documents/1013 ... sories.pdf

Can't find the cpap/apap machine allowable amounts but the code for the machine is E0601