RE: Beyond ASV with Overlap Syndrome!
Well it appears this thread saga is nearing a close, without the happy ever after.
Saw the CRNP at pulmonary this AM to discuss BPAP Titration results and that the ASV they want me to try again includes yet another Titration.
I refused. I asked why another Titration when we have this unresolved info. I stated the prior failure of ASV to fall out of sync. No timing controls means it will fail me. How about ST-A which is the same HCPCS code? No we can't do that, your respiratory disease either doesn't exist but they're still filling inhaler scripts, or the disease isn't bad enough. So you can't get ST-A because we only use those in hospitals. OK sure right.
I had a doctor visit to actually discuss this with the doctor in FEBRUARY. I changed my mind, I'm calling them now to cancel any other appointment. I'M DONE WITH THE GARBAGE!
OK, that's it. I surrender, I will go untreated. I despise the pulmonary doctors and insurance that block treatment.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Beyond ASV with Overlap Syndrome!
FWIW here's the billing info highlight from my last single BPAP Titration.
Total charges were $4,829! My copay was $10.00, which I'm very surprised and also thankful. But WOW, four thousand, eight hundred... for a test... 
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Beyond ASV with Overlap Syndrome!
Far more than the advanced ST-A machine you seek, yet the system still will not provide it.
RE: Beyond ASV with Overlap Syndrome!
Exactly. Ironic or crazy how much they'll pay to not provide proper therapy.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Beyond ASV with Overlap Syndrome!
Ah, that totally sucks...
What happens if you let them do the titration with the ASV? Because it will fail... Will they admit that it failed? Or will they just dispense the ASV that they spent even more mega-buck$$$ proving doesn't work?
And how does an RN -- not even a doctor, let alone a specialist -- get to decide this?
RE: Beyond ASV with Overlap Syndrome!
Admitted, I really don't know where this will go, if I submit myself to yet another Titration. I'm just completely fed up with the un-merry go round of test and discuss with no correct machine issuance. I have to bet with the odds though.
If I get the test done with issuing the ASV, it'll be about a month to test, then a month to discuss, at least a 3rd month to get the ASV. All these times are including scheduling and doing the visits involved. Add in another month trying to use it and failing. Now we're 4 months out, with 2 trips to Harrisburg for testing and discussion, and 2 to Hanover to get and return the ASV. I think they'd likely be too stubborn to go off the insurance script and I'd not be any better off than now.
No, I just can't make myself believe it will work out as needed. Not after 2 years of 4 separate pulmonary sleep teams all following their insurance script. At least this last Titration proves again correctly I have high pre-existing CA. These quacks cannot be trusted to not botch something yet again
If I get my car sold, I buy the ST-A. Otherwise the system fails to treat.
So that's it. I'm done with them period. Fini.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
04-14-2022, 07:56 AM
(This post was last modified: 04-14-2022, 07:58 AM by SarcasticDave94.
Edit Reason: Edit
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RE: Beyond ASV with Overlap Syndrome!
OK I have a little update. Due to my negative visit survey, Penn State Lemoyne Pulmonary office slotted me to see the top doctor in their system, Dr. Richard Evans. We talked about all my Pulmonary issues, the past, present, machines, successes and failures, that ASV therapy was right for a while and I felt lots better when it worked well, and so on. We talked on visit one for about 90 minutes. FWIW office staff say he's helped very complex cases to a successful conclusion.
I did decide on doing yet another PSG Diagnosic Sleep Study this past Tuesday in Lemoyne, PA. I could no longer accept not trying to force the system to get me the right machine. I had the same tech from several months ago that suggested standard BPAP would never work for me. He seems to have some influence on how the results are interpreted. Sometimes that's bad and other times it works in the patient's favor.
I'm also slated for a new PFT in June for Dr. Evans to decide if I actually have COPD or Asthma. It probably won't be till after that when doc decides on my therapy direction.
So same state sleep wise, bad. No change in the GERD yet either. So nothing much has changed except everyone is paying more for everything.
 and energy drinks every day or I'm napping all the time.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Beyond ASV with Overlap Syndrome!
Thank you for the update Dave. I still have the Trilogy Evo ventilator here at my home.
Did you ask him about doing an overnight capnometry/oximetry (cap/ox) test? Easy to do and results back same week was my experience. That test should provide evidence for hypoventilation from COPD - necessitating a ventilator. Mention "cap/ox" test (capnometry - end tidal CO2) to the tech, RN's, and everyone who will listen.
I wish you well Dave.
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RE: Beyond ASV with Overlap Syndrome!
I think I saw the doc before you'd suggested that test. I can bring it up June 6. I see doc immediately after PFT that day.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Beyond ASV with Overlap Syndrome!
Apologies if I missed this info earlier in the thread, but how much if any O2 are you using overnight?
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