insurance code for Bleep?

[onward60]

Hi, I'm having trouble with getting insurance coverage for Bleep. One DME (Lincare) is looking into it, but could not find an insurance code for a package of nasal masks. She's calling another location to see if they know how to code it, but she has never heard of anyone doing it. A tiny bit of hope is the other office at least has a sample pack to show to customers. Haven't heard back.

[Jlfinkels]

Try these two links…

https://www.thecpapshop.com/insurance-codes

viewtopic/t63634/What-is-CPT-code-for-n ... llows.html

[zonker]

Try these two links…

https://www.thecpapshop.com/insurance-codes

viewtopic/t63634/What-is-CPT-code-for-n ... llows.html

be interesting to see what the answer is. i ASSUME the bleep is considered a "nasal pillow" mask?

[Pugsy]

viewtopic.php?f=1&t=185680&p=1429414&hi ... 4#p1429414

See my post at above

Here's part of it
Insurance (all of them including Medicare) pay by HCPCS billing codes and the codes for the Bleep / Eclipse frame are
the frame/hose....A7034
and the halos....either A7033 which is the 2 per month allowed nasal pillows or the A7032 which is the nasal cushion code that allows 2 per month......insurance doesn't care.

[chunkyfrog]

Maybe it's the fact that Bleep needs no headgear.
One less thing to bill Medicare for . . .

[Janknitz]

Here's an order form from the Bleep website with the HCPCS codes just as Pugsy says:

https://bleepsleep.com/wp-content/uploa ... r-form.pdf

Eclipse intereface is A7034, the rings are A7033.

Sometimes you need something "official looking" for the DME.

[onward60]

.
What she said was there was a code for one nasal pillow per month, not for one box of nasal pillows. I'll see what she says about the codes when she calls back. And I'll try the "official looking" thing.

[Pugsy]

One box of ports is 2 weeks worth and is the equivalent to one replacement cushion.
So 2 boxes is equal to 2 cushions per month which is what insurance (even Medicare) normally allows.

[chunkyfrog]

I have been wanting to try Bleep.
Maybe my DME will consider ordering it, because two weeks worth of ports cannot be stretched out beyond 2 weeks, like silicone pillows or cushions.
Some folks can use a set of pillows for months--not possible with Bleep.

[jlsmithseven]

Just curious , why are the codes needed since DME don’t carry these. Every time I try to ask they say sorry we don’t support those, if you need anything else let us know. Am I missing something?

[chunkyfrog]

Just curious , why are the codes needed since DME don’t carry these. Every time I try to ask they say sorry we don’t support those, if you need anything else let us know. Am I missing something?

Find a DME that will ORDER them for you. (They should be covered)
The codes refer to categories of masks--whether or not they are "in stock".
Explain to the lazybones, and their bosses, why they lost you.
Certified mail shows you mean business.

[Janknitz]

I have been wanting to try Bleep.
Maybe my DME will consider ordering it, because two weeks worth of ports cannot be stretched out beyond 2 weeks, like silicone pillows or cushions.
Some folks can use a set of pillows for months--not possible with Bleep.

My guess is that there's not enough of a profit margin to make it worthwhile for only one patient. But if more people were asking for it, they might.

[lynninnj]

I am due for new mask next month and asked them to put the feelers out.

I suspect that the biggest PITA will be them making me go to the office to pick up supplies every 2-4 weeks.

[booksfan]

I am due for new mask next month and asked them to put the feelers out.

I suspect that the biggest PITA will be them making me go to the office to pick up supplies every 2-4 weeks.

That was the problem for me. My terrible insurance only allows one month at a time, so it was either $7 for shipping monthly or pick up. And the insurance copay for one month was what my prior insurance charge for THREE months! So it cost me less to order out of pocket online with free shipping! Anywhere from $5-15/month less depending on the sale +coupon.