This Noob's been ripped off - need advice.

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Slinky
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Re: This Noob's been ripped off - need advice.

Post by Slinky » Mon Dec 21, 2009 6:23 am

No, the ICD-9 codes are the diagnosis codes, i.e. 559.2 is Crohn's disease. I've forgotten the ICD-9 code for OSA. ICD means International Statistical Classifications of Diseases. ICD codes are alphanumeric designations given to every diagnosis, description of symptoms and cause of death attributed to human beings. These classifications are developed, monitored and copyrighted by the World Health Organization (WHO). In the United States, the NCHS (National Center for Health Statistics), part of CMS (Centers for Medicare and Medicaid Services) oversees all changes and modifications to the ICD codes, in cooperation with WHO.

HCPCS = Healthcare Common Procedure Coding System. HCPCS are the codes used by Medicare and monitored by CMS, the Centers for Medicare and Medicaid Services. They are based on the CPT Codes (Current Procedural Technology codes) developed by the AMA. There are two sets of codes. The first set, HCPCS Level I, are based on and identical to CPT codes, the codes developed by the American Medical Assocation. Level II HCPCS codes are used by medical suppliers other than physicians, such as ambulance services or durable medical equipment. These are typically not costs that get passed through a physician's office so they must be dealt with by Medicare or Medicaid differently from the way a health insurance company would deal with them.

You will also see CPT codes. CPT (Current Procedural Terminology) codes are numbers assigned to every task and service a medical practitioner may provide to a patient including medical, surgical and diagnostic services. They are then used by insurers to determine the amount of reimbursement that a practitioner will receive by an insurer. Since everyone uses the same codes to mean the same thing, they ensure uniformity. CPT codes are developed, maintained and copyrighted by the AMA (American Medical Association.) Thousands of codes are in use, and they are updated annually. Development and maintenance of these codes is overseen by editorial boards at the AMA, and the publications of all the software, books and manuals needed by those who use them brings an estimated $70 million in income to the AMA each year. You can access the CPT codes at:

http://patients.about.com/gi/o.htm?zi=1 ... who%3Ddone

So you see we are all just a number to our doctor, to our government ...

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BlackSpinner
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Re: This Noob's been ripped off - need advice.

Post by BlackSpinner » Mon Dec 21, 2009 11:50 am

So you see we are all just a number to our doctor, to our government ...
So maybe you want to go back to the insurance/billing trying to read your doctors handwriting? That would drastically increase the cost of the service LOL. I wrote one of those services 15 years ago because the docs could not manage to fill out even a punch card correctly. (actually the secretary tried to read his handwriting to fill out the punch card)

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DonR22
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Re: This Noob's been ripped off - need advice.

Post by DonR22 » Mon Dec 21, 2009 8:42 pm

I thank you all for your excellent advice. I am seeing my ENT specialist tomorrow. I'll post how it all turns out.

jules
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Re: This Noob's been ripped off - need advice.

Post by jules » Mon Dec 21, 2009 8:47 pm

get a copy of his original script for the machine, get a copy you can use for getting a new one etc.