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Medicare TReatment/Diagnosis Codes - Homerec130 - 01-22-2022
Having an issue with our DME and billing in regard to Medicare. My wife was on a Dreamstation AutoSV which her doctor said wasn't working for her. In fact, it was making things worse. She was then prescribed a ResMed Aircurve 10ST and she has seen some positive results with that. Even though she has had the Aircurve for about 10 months we just got a bill from the DME as they said Medicare denied the claim. It had been approved way back when, but now they are saying it hasn't.
I am looking to see if anyone has the codes for the Dreamstation AutoSV and the ResMed AirCurve 10 ST.
I am trying to lay some of the groundwork so I can talk to my wife's sleep doctor and get this resolved. On top of it, her sleep doc left the practice she was with and formed her own and we are in the process of trying to get her records from the prior practice where she was when the second machine was prescribed.The good news is the DME has marked the bill as being contested so the clock isn't running.
TIA
RE: Medicare TReatment/Diagnosis Codes - Gideon - 01-22-2022
http://www.apneaboard.com/wiki/index.php/Dealing_with_insurance_%26_Medicare#CPAP.2FBiPAP_MACHINE_INSURANCE_.28HCPCS.29_CODES:
CPAP/BiPAP MACHINE INSURANCE (HCPCS) CODES:[edit]
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) (VAuto, S)
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) (ST, T, ASV, iVAPS)
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
RE: Medicare TReatment/Diagnosis Codes - Homerec130 - 01-22-2022
Thank you. I did run a search on codes, but got nowhere.