Insurance Codes for CPAP Equipment ???

I am new to CPAP therapy (10 nights – Usage: 67hrs) and did quite a bit of research and reading this forum. This forum has been a great help in many aspects of the treatment from the sleep study to device selections.

One thing I have not had much luck on is understanding the insurance process. I had no problem getting all the equipment from the DME and got my “statement of benefits” from the insurance company that clearly showed what they paid for. What it never shows is the “procedure codes”.

I called my insurance company to ask about the procedure codes and learned that there are many and that the insurance company would not provide me a list. I tried Google and had some luck but I'm getting a bit confused between medicare (which is a long way away) and non-medicare codes.

I am looking for a complete list of CPAP equipment/supply proceedure codes AND the associated replacement schedule for various items. For example, filters may be 1 month, hose replacement - 6 months, mask – x months, etc. I suspect this is different depending on your insurance company, but I would hope there are some general guidelines followed by the insurance companies.

My insurance company will tell me the replacement schedule if I give them the procedure code but I want to have a complete list of proceedure codes so that I can maximize my insurance benefits.

As I indicated at the beginning, I am new and not sure this is a easy question to answer, but I thought it was worth a try. This forum has been helpful regardless of the question.

Thanks in advance for any help!

See if these lists help. Billing code search instead of procedure code got me these.
http://www.cpapsupplyusa.com/how-to-bil ... rance.aspx

http://www.sleepguide.com/forum/topics/ ... p-supplies

http://www.cpap-accessories.com/cart/in ... x&cPath=21

E0601 - CPAP machine purchase
A7034 - CPAP nasal mask
A7032 - CPAP nasal mask cushion
A7030 - CPAP Full Face mask
A7031 - CPAP Full Face mask cushion
A7044 - CPAP Full Oral Interface
A7046 - CPAP Humidifier Chamber
A7037 - CPAP tubing, long and short hoses
A7038 - CPAP disposable filter
A7039 - CPAP foam filter
A7035 - CPAP headgear
A7033 - CPAP nasal pillows
A7036 - CPAP chinstrap
E0561 - CPAP Passover Humidifier
E0562 - CPAP Heated Humidifier
E0470 - BiPAP purchase
E0471 - BiPAP-ST purchase
A4604 - Thermo Smart Tube
K0553 - Oral/Nasal (Hybrid) Mask
K0554 - Oral Cushion for Hybrid Mask
K0555 - Nasal Cushion for Hybrid Mask
E1399 - CPAP Miscellaneous (this code is to be used for any CPAP items covered by your insurance but not listed above.

"k" codes are temporary codes that have been replaced. The new codes are:

A7027 hybrid mask
A7028 hybrid cushions
a7029 hybrid pillows