Dreamstation auto-trial mode

[MarcS]

Hope you don't mind my hopping onto this thread, but I just underwent another sleep study where they weren't able to nail down proper settings, and didn't add O2, which I've been bleeding-in my old CPAP for well over a decade.

I was put on a Dreamstation BI-PAP Pro -- I believe that's a model 600 -- and my Dr. said I  should give A-Trial a try, and of course, lo and behold, it's not there.

Talked to Philips DIRECTLY and they said it should be on the PRO CPAP, PRO AUTO-CPAP, PRO BI-PAP, and PRO AUTO-BI-PAP ... 

In fact, this is directly from the User's Manual, describing A-Trial:

If Auto-Trial mode is available, this screen displays Days: xx/xx(where xx/xx is the number of accumulated trial days / number of selected trial days). Available on the Pro, Auto, BiPAP Pro, and BiPAP Auto models.

So, I talk to one of the respiratory therapists at Restitec (my assigned DME supplier), and she makes a few calls and comes back telling me that there are two models that DON'T have A-Trial -- the 400 CPAP, and the 600 BI-PAP Pro.  WTF?! 

My firmware is the latest 1.1.6 I believe that's current, so of course I had asked if they somehow disabled the A-Trial function on my machine prior to delivery -- blower motor had 0 hrs of use.  I just don't know and frankly feel rather ripped-off, seeing as how even my Dr. wanted me to give A-Trial a go.

I'm still dead-tired, have to take naps, and not waking up feeling refreshed.  And of course, they won't even consider making O2 saturation modules and equipment available through DME, they said they wouldn't even try.

For the record, I've tried BI-PAP 19/16, 21/17, and my old CPAP setting was 19.5.  Really feeling lost -- loaded Sleepyhead, but really don't know how to make heads or tails out of it, so will go with my Dr.'s suggestion of trying CPAP 20 tonight, and possibly BI-PAP 20/16.

Could really use some help, so thanks everyone, and hope I didn't hijack, but I felt it was up the same alley, so please let me know.

Respectfully Yours,

Marc

[ShaunBlake]

Marc, it sounds like your doctor expected the machine he prescribed to have A-Trial so the first thing is to call his office and notify them the machine you got doesn't have that feature.

Question: why are you trying to get supplemental O₂ – did your sleep study identify low O₂ saturation?  Oh, and did it determine that a BiPAP would address that?  (Mine identified low O₂ and required a second study, which revealed that BiPAP wouldn't fix it and I have to be on supplemental O₂ – but thanks God, I don't have to drag a bottle around with me during the day.

[MarcS]

Marc, it sounds like your doctor expected the machine he prescribed to have A-Trial so the first thing is to call his office and notify them the machine you got doesn't have that feature.

Question: why are you trying to get supplemental O₂ – did your sleep study identify low O₂ saturation?  Oh, and did it determine that a BiPAP would address that?  (Mine identified low O₂ and required a second study, which revealed that BiPAP wouldn't fix it and I have to be on supplemental O₂ – but thanks God, I don't have to drag a bottle around with me during the day.

Hey Shaun!  The A-Trial was more of an after-thought as they never were able to pin down an acceptable CPAP or BI-PAP Pressure with good O2 Saturation.  I had been on 2L/min O2 bleed-in for years after having been hospitalized for a severe upper respiratory illness.  Explained that going in, but she said there were "insurance issues" testing with O2 if they couldn't get a decent pressure-setting.  It was a split-test night and they ran out of time, apparently, all because the original doctor didn't sign my diagnosis of sleep apnea on my very first split-test decades ago.

I'm really lost -- I went to them because that was where I had received my original diagnosis, by that doctor had since retired.  Things just seem right there, and I should have gone someplace else.  Anyway, now it's up to me to try different pressures on my own and try to figure out what works best, but I have no idea how to interpret the sleepyhead software.

May have to go into a different sleep center, but don't know if insurance will cover another night -- probably not.  They wasted that opportunity. *sigh*

Hence I was hoping to put it in the hands of the machine to figure out what seemed best.  Once again *sigh*

[Sleeprider]

Ask for the prescription to be changed to a bilevel auto, and get the Resmed Vauto. The billing code for Bilevel is the same whether it's fixed or auto. If your doctor wants machine titration in auto mode, let him prescribe it!

[ShaunBlake]

May have to go into a different sleep center, but don't know if insurance will cover another night -- probably not.  They wasted that opportunity. *sigh*

Hence I was hoping to put it in the hands of the machine to figure out what seemed best.  Once again *sigh*

Ask for the prescription to be changed to a bilevel auto, and get the Resmed Vauto.  The billing code for Bilevel is the same whether it's fixed or auto.  If your doctor wants machine titration in auto mode, let him prescribe it!

Marc, what Sleeprider said! Your doc should readily agree, and with that machine, you can get much better therapy.  And worst case, even if your doc doesn't agree to Rx titration, it will collect info that the gurus here can use to help you.  (But I'm hoping doc will come through for you!)

[MarcS]

Ask for the prescription to be changed to a bilevel auto, and get the Resmed Vauto.  The billing code for Bilevel is the same whether it's fixed or auto.  If your doctor wants machine titration in auto mode, let him prescribe it!

Marc, what Sleeprider said! Your doc should readily agree, and with that machine, you can get much better therapy.  And worst case, even if your doc doesn't agree to Rx titration, it will collect info that the gurus here can use to help you.  (But I'm hoping doc will come through for you!)

I imagine I could get a script, but what will insurance think?  Since this is a replacement, it is being purchased by insurance outright -- no compliance check or monthly rental -- and I doubt they would front the funds for another machine.  Do DME companies offer return policies?  I figured once you had the equipment, that was it, you owned it ... done.

[Sleeprider]

The insurance reimbursement code (HCPCS) for bilevel-S and Bilevel Auto are the same. It costs the insurance exactly the same. It is the DME that makes more on a fixed pressure bilevel. The Code is E0470 and the description is:
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)

So Auto or fixed makes no difference to most insurance.