ordering cpap online; need procedure code for insur reimburs

[SleepyHibiscus]

Hi all, I am going to order my first cpap and mask online because local DMEs are not contracted w/ my insur. and they will balance bill me. I would be paying more than buying it outright. My insur. said I can order cpap equipment online and submit a claim: they will reburse 100% of the allowed amount if I submit the Dr.'s order, letter of diagnosis, Rx, purchase receipts, and the PROCEDURE CODE. How can I get a procedure code for a cpap machine and mask? Thank you!

Deb

[mousetater]

From cpap.com site:
https://www.cpap.com/cpap-faq/Insurance.html#198 lists all the codes.

[Wulfman]

SH,

Are these what you're looking for?

* EO601 RR is CPAP rental.
* E0601 NU is CPAP purchase.
* A7034 is CPAP nasal mask, including all nasal masks, Nasal Aire, Breeze, Spiritus.
* A7032 is CPAP nasal mask cushion.
* A7030 is CPAP Full Face mask.
* A7031 is CPAP Full Face mask cushion.
* A7044 is CPAP Full Oral Interface.
* A7046 is CPAP Humidifier Chamber.
* A7037 is CPAP tubing, long and short hoses.
* A7038 is CPAP disposable filter.
* A7039 is CPAP gross particle (foam) filter.
* A7035 is CPAP headgear.
* A7033 is CPAP nasal pillows.
* A7036 is CPAP chinstrap.
* E0561 NU is CPAP Passover Humidifier
* E0562 NU is CPAP Heated Humidifier
* E0470 RR is BiPAP rental.
* E0470 NU is BiPAP purchase.
* E0471 RR is BiPAP-ST rental.
* E0471 NU is BiPAP-ST purchase.

Other CPAP items are listed under E1399, which is miscellaneous.


E0601NU is what you would use for the CPAP machine.
E0562NU is what you would use for the Heated Humidifier

You'll have to figure out which number corresponds to the mask you want to get.

Best wishes,

Den

[SleepyHibiscus]

Thank you. Insurance Co. said they cannot reimurse me without the procedure code for the purchase. Thank you for providing them.[/img]