Approval letter questions

[MastrHiram]

Hi, everyone. I completed my compliance period a week or two ago. Yesterday, I received a letter from my insurance company's DME approval company, saying that I was approved for full purchase of my APAP machine (YAY!)

Then there is a list of Approved Services. There are many entries. Here are two as exaples:

A4606 - Tubing with Heating Element - 1 CPT units
A7029 - Nasal pillows for combination - 8 CPT units

I know that the first code is the HCPCS code each item, followed by the description of the item. What I don't understand is what in the heck "CPT units" are. Can someone explain it to me? Thanks.

[cdru]

I believe those units represent the amount of time allocated for a particular code where each unit is approximately 15 minutes of the therapists billable time. So the tubing would be good for 15 minutes of instruction where nasal pillows would be good for 2 hours, presumably to allow for fitting, adjustment, trial, etc. Or maybe I have no idea.

[MastrHiram]

Sounds like a good theory, but there are 12 "CPT units" for PAP filter. That CAN'T be right. LOL

[greatunclebill]

Current Procedural Terminology

A unit is the number of times a particular CPT code is used. Some CPT codes can only have 1 unit attached to them, others can have several.

[MastrHiram]

Thank you. Could this possibly refer to how many times a year a particular expense is covered? That would kind of make sense seeing as there are 12 units for the filter, 2 for full face mask, etc.