So is a titration study different?

Just got a call from the company trying to get my new machine stuff done and she said my last sleep study was a tritration study. Is this something different then a normal sleep study? She was having trouble because she said she needed my first study which I don't remember when that was. I also told her my first study they said I has apnea but it was not bad enough for medicare to cover the cost of a machine. It was not until my next study they said it had got bad enough to get them to pay for a machine

Titration study is where they hook you up to the mask and machine and figure out pressures.

The diagnostic study (without cpap or mask) is the one where it is proven that you need cpap and thus the titration study gets done.

You need a copy of the study that showed it was bad enough to get started on cpap...
how many sleep studies in total have you had?
Have you had 2 diagnostic sleep studies or just the one that showed things weren't so bad...which obviously isn't going to help you get a new machine.
Maybe a study where half the night was without cpap and the other half was with using the cpap..did you have one of those?

A Sleep Study is done without the mask to get a diagnosis.
A Titration Study is done with the mask to determine the pressure needed to prevent apneas.
Sometimes a Split Study is done where enough apneas happen in the first half without the mask to diagnosis and then for the second half they do the titration with the mask.

You may need a letter of medical necessity from your doctor in addition to results of the "questionable" study.
Obviously, your doctor ordered the titration study for a good reason.
Medicare may need to see that reasoning.

Well I think I have had 5 studies done. I had my first one but they said I did not meet the limits for medicare to cover a cpap. Had one not a year later that said medicare would now cover it. Since those 2 I had a couple more plus the titration a little over a year ago. Since they are having trouble getting my first study it will be another week before they are in this area again to deliver a new machine.

As for studies I've always had a mask on from the start so to me they were all the same. The did all the same things and I have been to 3 different places to do them. This last one was the first time I've been under a pulmonary doctor, most was just a regular doctor. You would think since medicare has been covering this for the last 5 plus years the doctor order for a new machine would not be a big deal. They should have all the paperwork

Medicare has some strange requirements. You must have a documented face to face meeting with the doctor where sleep apnea is discussed before your first sleep study is done. My first doctor ordered a sleep study, then a titration study without documenting a face to face meeting where sleep apnea was discussed. I ended up switching doctors and going through the whole thing a second time in order to get my machine.

"When they are in your area?" Nonsense!
Check with the Medicare site (link below) on who else can supply your equipment.
You may not be stuck with these turkeys!

Requirements when using Medicare are a little different when replacing machines and Medicare bought the first machine.
Medicare should have the needed documentation already from the diagnostic sleep study where they paid for the first machine.
Now the new DME might not have the needed documentation but Medicare certainly will have it.

The face to face visit with the doctor before a new machine is authorized is not negotiable.
That needs to be done. The doctor can give the DME all they need.

Well there is a place closer to me but they don't sell resmed so that is why I went to the next closest one, next county north. I can go to the office and pick it up if they get everything together, just might not have the time until next week.

Not sure on paperwork. The first doc that did this is no longer around and I don't think my new regular doc ever got my files from him. I would not think it would take that much to get with everything they put on computers these days

And I was at the pulmonary doc's office when he decided with my trouble I needed an autoset machine

chunkyfrog wrote:The face to face visit with the doctor before a new machine is authorized is not negotiable.
That needs to be done. The doctor can give the DME all they need.

That's already been done with the visit to the pulmonary doctor who has made the decision that he wants the autoset to get the data.

The next hurdle is the paperwork (copy of sleep study) that documents the need for cpap and the pulmonary doctor may not have that....but Medicare already has it because they got it from the first DME 5 years ago.
The new DME doesn't have the copy (and they need it because Medicare requires them to keep a copy) even though Medicare requirements in terms of diagnosis re the sleep study report...has been met.

If he was going through the original DME...they already have everything they need and Medicare was happy with it.
But he doesn't want to use them...so the new DME has to have some paperwork on file just like they would if he had never had Medicare involved.
Medicare has what they need already...it's just the new DME doesn't have everything that they need.