I ordered a P10 mask from Lincare. They billed my insurance this way: Does this seem correct? Or is it one code for a complete mask?
A7032- Nasal cushion/gel flap
A7034- Nasal Appl. device
A7035- Cpap headgear
A few months later, I ordered 2 replacement nasal pillows for the same P10 mask- and was billed A7033- nasal pillows.
None of this makes sense. Isn't there just One code when you order a complete mask? Thank you.
Does this billing make sense?
Does this billing make sense?
_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier |
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear |
Additional Comments: CPAP 10 cmH20., User since 1/1/15. |
Re: Does this billing make sense?
I am unsure about your case, but when I was doing rent to own
on my Airsense 10 apap, Lincare was charging me to rent both an apap with humidifier, and, separately, a humidifier. I called and was told thats just how it works...blah blah blah
on my Airsense 10 apap, Lincare was charging me to rent both an apap with humidifier, and, separately, a humidifier. I called and was told thats just how it works...blah blah blah
Re: Does this billing make sense?
Dave- who told you that is how it works- Lincare or your insurance co?
_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier |
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear |
Additional Comments: CPAP 10 cmH20., User since 1/1/15. |
- greatunclebill
- Posts: 1503
- Joined: Mon Feb 20, 2012 7:48 pm
- Location: L.A. (lower alabama)
Re: Does this billing make sense?
mask frames, headgear, cushions, pillows for insurance purposes are parted out because they are separate medical codes and billed to the insurance and you as code numbers. It's just the way things are done in the industry.
_________________
Mask: Quattro™ FX Full Face CPAP Mask with Headgear |
Additional Comments: myAir, OSCAR. cms-50D+. airsense 10 auto & (2009) remstar plus m series backups |
First diagnosed 1990
please don't ask me to try nasal. i'm a full face person.
the avatar is Rocco, my Lhasa Apso. Number one "Bama fan. 18 championships and counting.
Life member VFW Post 4328 Alabama
MSgt USAF (E-7) medic Retired 1968-1990
please don't ask me to try nasal. i'm a full face person.
the avatar is Rocco, my Lhasa Apso. Number one "Bama fan. 18 championships and counting.
Life member VFW Post 4328 Alabama
MSgt USAF (E-7) medic Retired 1968-1990
- chunkyfrog
- Posts: 34545
- Joined: Mon Jul 12, 2010 5:10 pm
- Location: Nowhere special--this year in particular.
Re: Does this billing make sense?
This is very common with insurance billing.
As long your bottom line is the lowest it can be, go with it.
If you can get anything online for less than your insurance copay, that is the way to go.
The best thing about self-pay is that you get what you need--exactly when you need it.
No insurance company schedules, deductibles, or vendors to deal with.
As long your bottom line is the lowest it can be, go with it.
If you can get anything online for less than your insurance copay, that is the way to go.
The best thing about self-pay is that you get what you need--exactly when you need it.
No insurance company schedules, deductibles, or vendors to deal with.
_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear |
Additional Comments: Airsense 10 Autoset for Her |
Re: Does this billing make sense?
Yeah, it's about right. There is no HCPCS billing code for a complete mask package that I am aware of.
It's always parted out that way.
While this is the Medicare replacement schedule...the HCPCS billing codes are universal no matter which insurance in the US is used.

It's always parted out that way.
While this is the Medicare replacement schedule...the HCPCS billing codes are universal no matter which insurance in the US is used.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier |
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/ |
I may have to RISE but I refuse to SHINE.
Re: Does this billing make sense?
Thanks everybody-
_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier |
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear |
Additional Comments: CPAP 10 cmH20., User since 1/1/15. |