ResMed vs Respironics CPAP machines

[Pesser]

I have used tried a Resmed and Remstar. They are both great machines. Having insomnia I have noticed a marked difference in sound. When the pressure delivered in low….say at a ramp starting a 6H20 the Resmed is louder. The Resmed did not respond in lower the sound given a different pressure. The Remstar did respond. The Remstar is less loud at say 6 than the Resmed. At 10H20 they were both the same; however if one needs lower sound; it is not achieved with Resmed.

[Stevoreno_55]

I am also in MS and wouldn't get supplies from LINCARE ever! Have heard to many bad things. I get my supplies from SleepLinks in Flowood near Jackson. Theyre all super nice and they will ship your items to you. And I do know they carry Resmed and Respironics products. Their number is 601-932-3744 if you want to check them out. Hope this helps

I tried to speak to someone at Sleeplinks today; I dialed the number in your post but nobody answered the phone; the phone just continued to ring as if nobody was home; no answering machine came on nor did an answering service take my call.

[Stevoreno_55]

I am with LSAT....if you can get a bilevel pressure machine it would be so much nicer using that 18 cm but you would definitely need a new RX from the doctor.

Insurance companies don't do the requiring so and so for APAP vs CPAP though...DMEs will tell you that but insurance companies don't care because they pay by HCPCS code and the code for the S9 Elite or the S9 AutoSet is the same. E0601...

So it is the DME who likes to blame things on the insurance company that is the road block in getting APAP/CPAP machine.
Now if your doctor (doesn't have to be a sleep doctor..can be your family doctor) writes a RX...and is specific about what to dispense...the DME has to do it but most of the time the doctor just says
"cpap at so and so pressure with heated humidifier" which leaves a lot of room for the DME to play with.

So if I had an autoset machine with a diagnosed pressure of 18 would the new machine be set to 18 or a much lower pressure?

Yes, it is possible that using an APAP/CPAP machine in Auto adjusting mode that you wouldn't have to use 18 cm all the time.
You might get by with less pressure part of the time and only spend maybe an hour or so at 18...or heck you might not need 18 at all...maybe the highest you need would be 16...of course you might be like me and sometimes need 20.
The 18 cm is a worse case scenario pressure...like my 20 cm that I might see for 30 minutes out of 8 hours.
So it's possible that you could get by with less pressure but can't guarantee it.

Do you have a regular primary care physician who might write a new RX for you?
Sleep study results aren't as important and a RX from a doctor.
If you can't get someone to give you a bilevel pressure machine (definitely would need new RX)....then go with a ResMed S9 machine. It's exhale relief works like a bilevel machine would work but is just limited to 3 cm reduction...better than nothing.
And yes.....I would push for the Autoset just in case you could maybe get by with less pressure at least part of the night.
With higher pressure needs...I think that the S9 with its EPR exhale relief probably is a better choice.

Here are some billing codes; what might be the reason for such a big difference in the two fee amounts? One might be for a straight CPAP and the other one for an auto CPAP?

E0601
CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICE
$749.44
E0601
CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICE
$374.72

[Pugsy]

Here are some billing codes; what might be the reason for such a big difference in the two fee amounts? One might be for a straight CPAP and the other one for an auto CPAP?

E0601
CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICE
$749.44
E0601
CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICE
$374.72

No, auto cpap doesn't have a separate code or fee.
Where did you get these numbers? Without seeing the other stuff and knowing where it came from it is impossible to know why the big difference but I it for sure is not because of auto cpap.
APAP machines get billed under the E0601 code because they are a CPAP machine...it just happens to have auto adjusting pressures..it's still continuous single pressure machine.

[Stevoreno_55]

Here are some billing codes; what might be the reason for such a big difference in the two fee amounts? One might be for a straight CPAP and the other one for an auto CPAP?

E0601
CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICE
$749.44
E0601
CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) DEVICE
$374.72

No, auto cpap doesn't have a separate code or fee.
Where did you get these numbers? Without seeing the other stuff and knowing where it came from it is impossible to know why the big difference but I it for sure is not because of auto cpap.
APAP machines get billed under the E0601 code because they are a CPAP machine...it just happens to have auto adjusting pressures..it's still continuous single pressure machine.

I got those numbers off of my insurance company's website looking through 81 pages of billable fee schedules. I called my insurance company for an explanation on the differences in the amounts; the CSR at my insurance company told me when I asked her that she did not know; good answer huh.

[Pugsy]

the CSR at my insurance company told me when I asked her that she did not know; good answer huh.

Yeah, good answer.

Doesn't make any sense but then again...common sense and insurance stuff rarely makes sense.
Maybe there is an asterick somewhere that didn't show up on the website or some special circumstance.

I can assure you it isn't because of a machine offering auto adjustable pressure mode. The people that handle these insurance claims don't know one model from another. They don't know what one machine offers and another might not offer and really could care less. They go by the code.

[Stevoreno_55]

the CSR at my insurance company told me when I asked her that she did not know; good answer huh.

Yeah, good answer.

Doesn't make any sense but then again...common sense and insurance stuff rarely makes sense.
Maybe there is an asterick somewhere that didn't show up on the website or some special circumstance.

I can assure you it isn't because of a machine offering auto adjustable pressure mode. The people that handle these insurance claims don't know one model from another. They don't know what one machine offers and another might not offer and really could care less. They go by the code.

Would it be possible that the larger $$ amount is for a BIPAP unit and the smaller $$ amount is for a CPAP unit? I plan to give them a call back next Monday if they're open since it's a government holiday otherwise I might have to wait and call them next Tuesday.

[Pugsy]

BiPaps would likely be quite a bit more expensive and the HCPCS code is not E0601 which is for cpap/apap machines.

BiPap code for regular BiPap (not ASV) is E0470

ASV bilevel with backup rate machine...code...E0471


$374 dollars for a E0601 cpap machine...that's really a low amount...even medicare allows more than that.
That's more in line with what the humidifier normally gets allowed.

Wonder if that is a typo and should be humidifier for E0601 machine???

[sol]

Would it be possible that the larger $$ amount is for a BIPAP unit and the smaller $$ amount is for a CPAP unit?

Smaller amount is 50% of the larger amount
Only a guess ... the smaller amount is what Medicaid pay and Medicare pay the other 50%

[Stevoreno_55]

BiPaps would likely be quite a bit more expensive and the HCPCS code is not E0601 which is for cpap/apap machines.

BiPap code for regular BiPap (not ASV) is E0470

ASV bilevel with backup rate machine...code...E0471


$374 dollars for a E0601 cpap machine...that's really a low amount...even medicare allows more than that.
That's more in line with what the humidifier normally gets allowed.

Wonder if that is a typo and should be humidifier for E0601 machine???

OT: Do you know if Philips-Respironics will allow me to ship my 6 year old Philips-Respironics DS400S CPAP machine back to them for a fee to have them check my heated humidifier out to determine if it's still working properly or if I need to replace it or will they tell me to take my CPAP machine back to the DME who got it for me back in January 2008; Apria Healthcare; who is no longer my DME?

[Pugsy]

I don't know what Respironics would do for a 6 year old machine but they don't normally accept machines, even returned under warranty, directly from patients. Has to come from a DME. I don't think it has to be the original DME though.

http://www.acbio.com/
You might check with these folks.
Though it's likely going to cost more to ship and check it out...and fix it and then back to you..than it is worth.

[Stevoreno_55]

I don't know what Respironics would do for a 6 year old machine but they don't normally accept machines, even returned under warranty, directly from patients. Has to come from a DME. I don't think it has to be the original DME though.

http://www.acbio.com/
You might check with these folks.
Though it's likely going to cost more to ship and check it out...and fix it and then back to you..than it is worth.

Thanks for the information and the link you provided.