Dreamstation ASV not helping, help needed.

[ajack]

The o2 sleepyhead charts I've seen here look just like yours and oscillate. There are a few bigger dips in the second chart that are worth looking at. You need the machine data to know what is happening. You may need to use a library computer or find a program that will work in macbook. You are going to need to see what is going on.

For now, the machine AHI, may give enough to adjust your min epap? If you have min epap 4, I would guess you are having obstructive apnea still and is probably the reason for the few larger dips. Like other XPAP machines. the min pressure needs to be enough air splint, to keep your throat open.

[chicken]

I have to post a response on DME billing i looked into it and i now see what i was missing/wrong.
the codes used are generic so i now see why everything is charged that way.
i am reading that it should have a kx modifier - document on file to explain in detail what was sold/rented/ect..
so i am guessing at this point there is a file at the DME that explains the billing that i have not seen?
E0601 CPAP device is all thats posted, ill ask for the modifier.

[Sleeprider]

The HCPCS code E0601 is a CPAP machine. Bilevel is E4070 and your ASV is a bilevel with backup rate E0471. Here are a few more...

CPAP/BiPAP MACHINE INSURANCE (HCPCS) CODES
E0601 Continuous airway pressure (CPAP/APAP) device
E0470 Respiratory assist device, bi-level pressure (BiPAP) capability, WITHOUT backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)
E0471 Respiratory assist device, bi-level pressure (BiPAP) capability, WITH backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)
E0472 Respiratory assist device, bi-level pressure (BiPAP) capability, WITH backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)
E0561 Humidifier, non-heated, used with positive airway pressure (CPAP/BiPAP/APAP) device
E0562 Humidifier, heated, used with positive airway pressure (CPAP/BiPAP/APAP) device
CPAP/BiPAP MASK INSURANCE (HCPCS) CODES
A7030 Full Face Mask used with Positive Airway Pressure (CPAP/BiPAP/APAP) Device
A7034 Nasal interface (mask or cannula type) used with positive airway pressure (CPAP/BiPAP/APAP) device , with or without headstrap
A7044 Oral interface used with positive airway pressure (CPAP/BiPAP/APAP) device
A7027 Combination oral/nasal mask, used with continuous positive airway pressure device
CPAP/BiPAP PART & ACCESSORY INSURANCE (HCPCS) CODES
A7028 Replacement Oral Cushion for Combination Oral / Nasal Mask
A7029 Replacement Nasal Pillows Cushion for Combination Oral / Nasal Mask
A7031 Replacement Cushion for Full Face Mask
A7032 Replacement Cushion for Nasal Mask
A7033 Replacement Pillows for Nasal Pillows or Cannula Style Mask
A7035 Headgear used with positive airway pressure device
A7036 Chinstrap used with positive airway pressure device
A7037 Tubing used with positive airway pressure device
A4604 Heated Tubing used with positive airway pressure device
A7038 Filter, disposable, used with positive airway pressure device
A7039 Filter, non-disposable (reusable), used with positive airway presssure device
A7045 Exhalation port with or without swivel used with accessories for positive airway pressure devices
A7046 Water chamber for humidifier, used with positive airway pressure device
E1399 Miscellaneous Durable Medical Equipment Items, Components and Accessories
NEBULIZER & COMPRESSOR INSURANCE (HCPCS) CODES
E0570 Nebulizer, with compressor
A7005 Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable
A7004 Small volume nonfiltered pneumatic nebulizer, disposable
A7003 Administration set, with small volume nonfiltered pneumatic nebulizer, disposable
A7015 Aerosol mask, used with dme nebulizer
A7014 Filter, nondisposable, used with aerosol compressor or ultrasonic generator
A7013 Filter, disposable, used with aerosol compressor or ultrasonic generator
A4627 Chamber, with or without mask, for use with metered dose inhaler
LIGHT THERAPY DEVICE INSURANCE (HCPCS) CODES
E0203 Light Therapy Device
OXYGEN CONCENTRATORS & SUPPLIES INSURANCE (HCPCS) CODES
E1356 Oxygen accessory, Battery pack
E1357 Oxygen accessory, Battery charger
E1358 Oxygen accessory, DC Power Adapter
E1390 Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate
E1392 Portable oxygen concentrator
E0445 Oximeter device for measuring blood oxygen levels non-invasively
A4615 Oxygen nasal cannula
A4616 Oxygen supply tubing

[WillSleep]

Hi Chicken, 

I feel I need to and so give strong attention to working to optimize SpO2 & other heart related metrics.  

First: Having acknowledged respect for your focus on the cardio topics above I would encourage you to first focus on ASV for AHI/Apnea/Sleep Quality:

• Treat the ASV + AHI metrics as related but separate metrics from SpO2 and other heart / cardio metrics.
  
• Yes sort out the questions on your pulse ox as mentioned above
  
• But also look first to the ASV + the recommended Sleepyhead approaches common to this forum as a means to reduce Apenas and improve your overall sleep quality and effectiveness, and then second look to see if you can use or tune the ASV to further improve SpO2 and other heart metrics.
  
• I recommend posting the ASV charts as described in these links Sleeprider posted and then the group can help you with the ASV config and use topics for AHI/Apneas:   Organize your SleepyHead Data        Post your SleepyHead Data from Imgur        
  

Second: Assess and if needed further tune ASV or any xPAP therapy to further improve SpO2 or other cardio related metrics.

Third:  You raised the question if you actually need the ASV. Maybe you do, maybe you don't??
For me personally the ASV (especially in default settings) did wonderful things for my AHI but actually lowered my SpO2 and added stress/reduced the quality of my other heart (cardio) related overnight metrics.   I found the APAP better for my heart metrics and the ASV better for lowering AHI.  I was surprised and disappointed by the negative cardio related overhead that came with the switch to the ASV.    Overall, after balancing the tradeoffs, for me the AVS is helping me achieve my health goals better than the APAP did - your mileage my vary.  

So I encourage you to continuing the honest questions you opened with and keep testing to see if the ASV, any xPAP or any other therapy really helping or hurting you achieve your health goals.    Keep what is best for you personally as the goals and measures your evolving therapy strategy is molding around.

J

[HalfAsleep]

You may need to use a library computer or find a program that will work in macbook. You are going to need to see what is going on.

I use a MacBook. It is the only computer I have. I use SleepyHead. No Mac issue. Just like everyone else. No prob. 

The SPO2 data is a whole 'nother Mac problem.

[chicken]

ok update, my original sleep test came in at 7.6 AHI half were centrals.
with ASV its now averaging 4.8 all hypo apnea's. varies 2.8 to 10.6.
i would need to crank the pressure up to 19 to get rid of my hypo's.
in sleep test they ran that BIPAP up to 19/15 before switching to ASV in the last 40 min.
SPo2 no change with/without ASV.
SPo2 noticeable change with neck brace head propped up.
ASV with neck brace/head propped up I get periodic breathing?
I think ill just return the ASV, and try the neck brace/head propped up some flownase/nasal strips
and see what my SPo2 looks like.
it will get rid of the stress of having to use the ASV 4 hours per night to or else medicare police will get me.
i need to save my ASV sleep data so i can view it latter.
i had no problem with my cfs50 oximeter with sleepyhead, seems accurate.
at doctors office my SPo2 was 97 and my oximeter showed 97.
I bought one for my primary doc. as he did not believe they cost under 50.
i now have to wait several months to see the pulmonary doc. as i was just seeing the nurse.

[chicken]

I see the medicare code but what does that include/not include?
how do you find out?
it just says CPAP.
is it , CPAP, power cord, cary case, filters, hose?
does it differ if its say rented vs sold/rent to own?
filter and hose not counted do to being disposable? 
oh my "mask kit" has two codes on it? one for head gear who knew? its a kit?
that little peace of plastic with defuser 175. headgear 54 medicare/shaft.
online it says,
This Product Includes...

• DreamStation Auto Machine
  
• Hose
  
• Dark Blue Reusable Filter (Installed)
  
• Light Blue Disposable Filter (Uninstalled)
  
• SD Card (Installed)
  
• 80W Power Supply
  
• Power Cord
  
• User Manual
  
• Carry Bag
  

[ajack]

I know you wouldn't but I'd change the time and watch TV with it on for a couple of hours. yes it will go stupid with awake breathing. I'd try and be consistent in my breath. You are sincere in wanting to get this fixed and you are having a hard time. It will also get you more use to it.

As you found out. An ASV is a whole other ball game to get use to, nothing anyone says will prepare you for it.

can you put up the sleep report on the O2. If the bipap had it ok, we can probably steal those settings as a base/min for the ASV