Does this billing make sense?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Cardsfan
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Does this billing make sense?

Post by Cardsfan » Sat Dec 23, 2017 6:33 pm

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.

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bigdave36
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Location: Southern Illinois

Re: Does this billing make sense?

Post by bigdave36 » Sat Dec 23, 2017 6:51 pm

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

Cardsfan
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Joined: Wed Apr 29, 2015 3:02 pm
Location: Close to St. Louis, MO

Re: Does this billing make sense?

Post by Cardsfan » Sat Dec 23, 2017 6:56 pm

Dave- who told you that is how it works- Lincare or your insurance co?

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Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
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greatunclebill
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Re: Does this billing make sense?

Post by greatunclebill » Sat Dec 23, 2017 7:08 pm

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.

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chunkyfrog
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Re: Does this billing make sense?

Post by chunkyfrog » Sat Dec 23, 2017 8:09 pm

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.

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Pugsy
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Re: Does this billing make sense?

Post by Pugsy » Sat Dec 23, 2017 8:12 pm

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.

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Cardsfan
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Joined: Wed Apr 29, 2015 3:02 pm
Location: Close to St. Louis, MO

Re: Does this billing make sense?

Post by Cardsfan » Sat Dec 23, 2017 8:21 pm

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.