Radiologist Prescribes CPAP?

[khvn]

My friend is an ex-cpapper who wants to start treatment again after a hiatus. He wants to skip the sleep test and get the equipments (machine + mask) via a prescription by his nephew who happens to be a radiologist.

My friend is knowledgable about his own treatment, but I never heard of radiologists prescribing CPAP before so I thought I ask if anyone has seen anything like this done before. Also, if this can be done would medicare, which my friend has, agree to cover it?

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[jdavis123]

How long has the hiatus been? Radiologists don't prescribe CPAP but who's to say he couldn't write one (the Radiologist is the one who could potentially get in trouble though).

[tomjax]

Docs have been prescribing for friends and neighbors for years, but it may not be legal.
Many times, this is ignored by authorities..

I remember many cases of this happening in Fl with docs on vacaition.
One case was a dentist on vacation who wanted to get some amoxicillin for a child- not his own.

I refused to fill it.

Regulations are that a practitioner may prescribe to a bona fide patient
in the course of his/her professional practice.
They may not prescribe while in another state than the one they are licensed.
I think all the above is still accurate.

If the radiologist has a genuine patient-doc relationship and the PAP is prescribed as a result of that connectino, then it is OK.

This situation is not normally enforced strictly, but mostly in cases of abuse.

[Beulah]

Sure; why not? Radiologists graduate from medical school with a full medical degree, then go on to additional years of study of radiology. Therefore they are "full doctors" perfectly capable of writing a prescription, making a diagnosis, rendering treatment, etc.

I'm not up on state licensure guidelines, but perhaps that doesn't apply in this case?

Since your friend is so knowledgeable about his own care, I personally don't see a problem with this. The only negative I see is the possibility of the doc being sued if something goes wrong and not having a lot of backup for his defense, but since it's his uncle, I doubt there'd be anything like that - or at least I hope not.

[Guest]

If he is only a Radiologist, Medicare will deny the claim unless he has another specialty as well.


From the Medicare guidelines for NIPPV criteria:

The "Treating Physician" must be one who is qualified by virtue of experience and training in non-invasive respiratory assistance, to order and monitor the use of respiratory assist devices (RAD). Physicians who treat patients for other medical conditions may or may not be so qualified, and if not, though they may be the treating physician of the beneficiary for other conditions, they are not considered the "Treating Physician" for the administration of non-invasive positive pressure respiratory assistance therapy.


AKCPAPGUY

[khvn]

[quote="Anonymous"]If he is only a Radiologist, Medicare will deny the claim unless he has another specialty as well.


From the Medicare guidelines for NIPPV criteria:

The "Treating Physician" must be one who is qualified by virtue of experience and training in non-invasive respiratory assistance, to order and monitor the use of respiratory assist devices (RAD). Physicians who treat patients for other medical conditions may or may not be so qualified, and if not, though they may be the treating physician of the beneficiary for other conditions, they are not considered the "Treating Physician" for the administration of non-invasive positive pressure respiratory assistance therapy.


AKCPAPGUY

[wlo2008]

Medicare and state insurances can be more tuff with things like this. Because most of the time they cover the whole cost. So they want to make sure it is worth their money. I have Mercycare throught the state. And my doc was worried that I would have to have another sleep study with the type of machine they wanted me on. I was lucky not to have to go through another sleep study because my first sleep study was so bad.

Even though one might want control over there theraphy all together. It is still a good idea to have a qualified sleep doc to work with. There are some out there. I have a great Neuro sleep doc.

[akcpapguy]

KHVN,

That paragraph is quoted from a printout on the CMS website, my Manager printed it and gave it too me. I'm not sure if she had to login to get to the area with that info, I will check into it tomorrow and let you know what I find out.

[Snoredog]

law only requires a prescription by a licensed medical doctor. He had to be a MD before a Radiologist MD, he could use the old PSG results to cover his rear, he could also use a report from an autopap.

insurance coverage is a different story.

[rested gal]

khvn, if your friend plans to buy the machine out of his own pocket from an online store, a prescription from ANY medical doctor will do.

[Guest]

KHVN,

Sorry I can't direct link because I can't stay logged in at work. Here is the link though.


http://www.cms.hhs.gov/mcd/viewlcd.asp? ... how=all#13

[Guest]

Hmm it did link, well good enough. Let me make it clear, I was ONLY addressing your question about Medicare paying for the cpap.

Like Snoredog said, ANY MD can write the script, getting your insurance to pay for it is the sticky part.


AKCPAPGUY

[Wulfman]

Hmm it did link, well good enough. Let me make it clear, I was ONLY addressing your question about Medicare paying for the cpap.

Like Snoredog said, ANY MD can write the script, getting your insurance to pay for it is the sticky part.


AKCPAPGUY

AKCPAPGUY,

Would you please check your e/g-mail?

Thanks,

Den

[Guest]

Will do when I get home Den, can't access it here at work.

[Wulfman]

Will do when I get home Den, can't access it here at work.