multiple codes on mask?

When I purchased my Swift FX mask, my DME listed it under three codes:
-7034 NASAL CPAP MASK 105.00
-7035 CPAP HEADGEAR 38.85
-7037 CPAP TUBING 28.15
TOTAL 172.00
When I questioned the tubing charge, they explained that was the tube at the front and was separated out so the insurance would pay the appropriate amount (90% of their price)
Does everybody do this? This sounds a little fishy.

chunkyfrog wrote:When I purchased my Swift FX mask, my DME listed it under three codes:
-7034 NASAL CPAP MASK 105.00
-7035 CPAP HEADGEAR 38.85
-7037 CPAP TUBING 28.15
TOTAL 172.00
When I questioned the tubing charge, they explained that was the tube at the front and was separated out so the insurance would pay the appropriate amount (90% of their price)
Does everybody do this? This sounds a little fishy.

Only the brick & mortar establishments. That's how they manage to maximize their profits.
Cpap.com's price on the complete setup is $127.00.


Den

How is it coded?
mask and headgear only?

Since cpap.com does not deal with either insurance or Medicare, they don't have to code anything.

My insurance is supposed to reimburse me 80% of authorized purchases I make out of network.
So, if I purchase a Hybrid mask, it's up to me to submit the paperwork.
I thought someone had mentioned in another thread that cpap.com will supply us those codes as a convenience to the customer.

jdm2857 wrote:Since cpap.com does not deal with either insurance or Medicare, they don't have to code anything.

Well, they DO put the insurance billing codes on the invoice that is sent out with the order. Usually, they put all of the applicable numbers on one line with the item description and price. (I just looked at one of my old invoices that I had scanned)
If the person's insurance provider reimburses them for a percentage of the purchase, the person can use that information to create their own invoice to submit to the insurance provider. (like I did)


Den

Excellent!
I think I'll use up my entire deductible with them!
Too bad my max out of pocket doubles out of network.
Friggin' insane!