didn't sleep during titration

[SleepyCabeza]

Hi all, newbie here. Went to the initial sleep study, and was diagnosed with apnea, particularly bad during REM (AHI = 31). Went to the titration and because of the mask (was a nose mask while I'm a mouth breather, and lab only had 1 other full face mask the tech didn't even want to try out) I didn't sleep a wink. It was the worst experience of my life. Test was a total waste. I made an appointment with the sleep doc to consider what my options are, besides another titration. I do not want to go thru that again and the wife is giving birth to our son and don't want to be away from home for a night. . Should I ask the doc for a APAP machine??? Should I ask for a CPAP machine and just set it based on the available data we have and go from there? Any advice would be appreciated. Did I mention I absolutely want to avoid another titration?

[chunkyfrog]

The lab should not get paid.
They should have had a mask that would work or cancel the study.

[Julie]

Fight for an Apap because it does Cpap as well, but the reverse is not true... plus you can titrate at home with the Apap.

[SleepyCabeza]

The lab should not get paid.
They should have had a mask that would work or cancel the study.

I agree. This lab was really low-rent. Some of the rooms didn't even have remote controls for their tv. The tech had to take the one in my room to give to someone else who wanted to watch tv.

[SleepyCabeza]

Fight for an Apap because it does Cpap as well, but the reverse is not true... plus you can titrate at home with the Apap.

Yeah I think I'm going to try this. Though I understand from reading here and elsewhere many docs are opposed to Apaps. Not sure why.

[Julie]

Maybe has something to do with their ignorance of Cpap in general (or believing that Apaps cost more insurance-wise, which is definitely not true, whatever the DME tells you!). Doctors may know the science of apnea, but way too few understand the equipment!

[SleepPlease]

I was diagnosed last month. Took 3 titration studies to diagnose me (can't wait for the bill for those). First night was horrible. Probes up the nose kept itching, then the CPAP made me feel like I was scuba diving. I slept maybe 2 hours tops.

2nd night was better but that's not saying much. I slept maybe 3 hours. I was worried about having to get up to go to the bathroom all wired up, and the tech seemed annoyed at the prospect. Sure enough, nature called but I powered thru it because I didn't want to annoy the tech. She kept coming in and telling me I'd better get to sleep or they won't get the results they need. I don't know about y'all, but nothing puts me in a sleepy mood like a head full of wires, an ill-fitting Darth Vader mask, and a curmudgeonly tech saying I better go to sleep or else...

3rd night was better. I asked my doctor for a sleep aid. That put me out quick and kept me out for about 5 hours. 3rd time's the charm, I guess. Still, the overall process of getting diagnosed was pretty horrible.

I don't know all the machinery or lingo yet, but my advice would be to find a different sleep place, if possible. Sounds like this company is pretty subpar.

[LaurieP]

My doctor wanted to do a titration study but I said no way. One time in a sleep lab was enough for me. She gave me a APAP and I did it at home and with the help of this site. To this day she is very impressed with my knowledge and lets me make the adjustments that I want and just follows up with the prescription to the DME/Insurance. This month was 3 years, not bad!!

[SleepyCabeza]

I was diagnosed last month. Took 3 titration studies to diagnose me (can't wait for the bill for those). First night was horrible. Probes up the nose kept itching, then the CPAP made me feel like I was scuba diving. I slept maybe 2 hours tops.

2nd night was better but that's not saying much. I slept maybe 3 hours. I was worried about having to get up to go to the bathroom all wired up, and the tech seemed annoyed at the prospect. Sure enough, nature called but I powered thru it because I didn't want to annoy the tech. She kept coming in and telling me I'd better get to sleep or they won't get the results they need. I don't know about y'all, but nothing puts me in a sleepy mood like a head full of wires, an ill-fitting Darth Vader mask, and a curmudgeonly tech saying I better go to sleep or else...

3rd night was better. I asked my doctor for a sleep aid. That put me out quick and kept me out for about 5 hours. 3rd time's the charm, I guess. Still, the overall process of getting diagnosed was pretty horrible.

I don't know all the machinery or lingo yet, but my advice would be to find a different sleep place, if possible. Sounds like this company is pretty subpar.

Holy moly!! Props to you for going through 3 titration studies. No way I'm going through 3. Heck, I'm going to do everything not to have to do a second one.

[SleepyCabeza]

My doctor wanted to do a titration study but I said no way. One time in a sleep lab was enough for me. She gave me a APAP and I did it at home and with the help of this site. To this day she is very impressed with my knowledge and lets me make the adjustments that I want and just follows up with the prescription to the DME/Insurance. This month was 3 years, not bad!!

Wow. That sounds fantastic. Did it take alot of convincing by you for your doc to skip a titration and just go to APAP instead?

[Guest]

I got lucky and my sleep dr prescribed an APAP instead of a titration study, although the fact that I had to do three diagnostic studies (first one a couple years ago undiagnostic, second showed apnea and PLMD, and third was to check up on the PLMD treatment effectiveness) may have had something to do with it. Sorry you had such a rough night. Best wishes.

[Stevoreno_55]

Maybe has something to do with their ignorance of Cpap in general (or believing that Apaps cost more insurance-wise, which is definitely not true, whatever the DME tells you!). Doctors may know the science of apnea, but way too few understand the equipment!

Is the billing code for an APAP the same as for a CPAP? Just curious.


Stevoreno_55
MS Gulf Coast
05/19/14

[Pugsy]

Is the billing code for an APAP the same as for a CPAP? Just curious.

Yes, the same billing code for either. E0601. An APAP is really nothing more than cpap mode with auto adjusting pressure.
APAP machines are 2 machines in 1....there is of course APAP mode available hence the APAP machine moniker but it also has CPAP mode available. That's how come you can buy an APAP machine with a CPAP RX online....it's really just a CPAP machine with auto adjusting pressure mode available.

We don't have different HCPCS billing codes until we get to the bilevel pressure machines (BiPap for Respironics or VPAP for ResMed) and then of course the high end bilevel machines have a back up rate available and they get another HCPCS billing code.

[Stevoreno_55]

Is the billing code for an APAP the same as for a CPAP? Just curious.

Yes, the same billing code for either. E0601. An APAP is really nothing more than cpap mode with auto adjusting pressure.
APAP machines are 2 machines in 1....there is of course APAP mode available hence the APAP machine moniker but it also has CPAP mode available. That's how come you can buy an APAP machine with a CPAP RX online....it's really just a CPAP machine with auto adjusting pressure mode available.

We don't have different HCPCS billing codes until we get to the bilevel pressure machines (BiPap for Respironics or VPAP for ResMed) and then of course the high end bilevel machines have a back up rate available and they get another HCPCS billing code.

So are most DME's reluctant to provide a patient with an APAP machine if the reimbursement rate the DME will receive from a patient's insurance plan is no more than what they would receive for issuing a patient a basic CPAP machine? So would a basic "brick" CPAP machine also have the same billing code as a data capable CPAP machine?


Stevoreno_55
MS Gulf Coast
05/19/14

[Pugsy]

So would a basic "brick" CPAP machine also have the same billing code as a data capable CPAP machine?

Yes, a brick gets the same HCPCS code as the full efficacy data machines...E0601

So are most DME's reluctant to provide a patient with an APAP machine if the reimbursement rate the DME will receive from a patient's insurance plan is no more than what they would receive for issuing a patient a basic CPAP machine?

Correct. APAPs cost the DME more money than the bricks cost them...they make more money selling bricks since the insurance company pays by HCPCS code and not by brand or model.
The cost difference isn't a huge amount though but $50 or $100 multiplied by 100 or 1000 adds up.