Sleepyhead help

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Drowsy Dancer
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Joined: Mon Feb 28, 2011 9:35 am
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Re: Sleepyhead help

Post by Drowsy Dancer » Mon Jan 18, 2016 3:04 pm

palerider wrote:
Drowsy Dancer wrote:The billing code is (or used to be) E0601 for all machines up to but not including bilevel
Thank you, I never can remember the codes.
It may have changed with the advent of ICD-10 but there should be a crosswalk for now. Hold please for additional research.

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Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: Swift™ FX Bella Nasal Pillow CPAP Mask with Headgears
Additional Comments: Software: SleepyHead. Pressure: APAP 9.5 min/11 max, A-Flex x2
How we squander our hours of pain. -- Rilke

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Drowsy Dancer
Posts: 1271
Joined: Mon Feb 28, 2011 9:35 am
Location: here

Re: Sleepyhead help

Post by Drowsy Dancer » Mon Jan 18, 2016 3:10 pm

Upon preliminary research (I'm far from an expert at this) it appears that HCPCS ("hick picks") codes, which are used to bill insurance for DME (durable medical equipment), have not been touched by the change from ICD-9 to ICD-10. Curious.

I *think* that the lack of chance *may* be limited to DME. In other words, if you have a medical *procedure,* or get a *diagnosis,* the code has changed, but they haven't changed the codes used for *supplies.*

For recreational reading: https://www.cms.gov/Outreach-and-Educat ... 900943.pdf

_________________
Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: Swift™ FX Bella Nasal Pillow CPAP Mask with Headgears
Additional Comments: Software: SleepyHead. Pressure: APAP 9.5 min/11 max, A-Flex x2
How we squander our hours of pain. -- Rilke

red_roni
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Joined: Sat Jan 09, 2016 12:01 am
Location: Houston, Texas

Re: Sleepyhead help

Post by red_roni » Mon Jan 18, 2016 5:32 pm

I went to my doctor's office today. The lady that I need to talk to was not there. She will be there with my doctor tomorrow. I spoke to another person. She looked at my records and the doctor did not specify in his notes which machine to give me. She said that they could ask him tomorrow which machine he wants me to have when I come in to see the equipment person. She seemed to be optimistic since I have only had my machine for 25 days. I think this is going to turn out OK. I am ready for the fight. My insurance paid them $860 for my machine. That means that they made money by giving me the basic machine. The way technology is changing, if I have to keep this machine for several years, I am already starting out behind. I will post an update tomorrow. Thanks again.

_________________
Machine: AirSense™ 10 CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Cardinal Ruby style chinstrap to keep mouth closed.