Tag: Bi-Level PAP
ResMed: Bi-level therapy can save adherence
June 5, 2018HME News Staff
BALTIMORE - A ResMed-sponsored study shows that shifting patients who are struggling with adherence to a PAP device to a more advanced bi-level device in the first 90 days of treatment is an effective tool in more than half of cases. In the study, ResMed compared 1,496 non-compliant patients who switched to bi-level therapy and found that compliance was achieved by 58.5% of patients who switched before day 60, 54.2% of patients who switched between days 60-90, and 56.8% of patients overall. “Finding...
DME MACs clarify vent requirements
May 6, 2016HME News Staff
WASHINGTON - In highly anticipated clarifications on coding and coverage requirements for ventilators, the DME MACs have acknowledged that coverage for the product category isn't quite black and white.While the National Coverage Determination stipulates that vents are covered for neuromuscular diseases, thoracic restrictive diseases and chronic respiratory failure, the DME MACs acknowledge that these disease groups overlap conditions described in the local coverage determination for respiratory assist...
Respiratory groups seek changes to ventilator NCD
April 7, 2016HME News Staff
WASHINGTON - The American Association of Respiratory Care, the American College of Chest Physicians and the National Association for Medical Direction of Respiratory Care have submitted a request for a reconsideration of the current Medicare National Coverage Determination for home ventilators, including bi-level devices. The groups would like Medicare to establish specific definitions for chronic respiratory failure, as well as for mechanical ventilators/ventilation, and to create objective, consistent...
Some claims in limbo as Medicare clamps down on vents
September 25, 2015Theresa Flaherty, Managing Editor
YARMOUTH, Maine - HME providers are struggling with how to get paid for COPD patients who fail Bi-level PAP therapy but don't require nearly around-the-clock ventilation.In April, CMS issued several bulletins clarifying the coding and coverage criteria for Bi-level devices vs. vents and the aftermath, for some providers, has been denials.“What Medicare is saying is that it needs to be a life or death situation, so if they are not on the ventilator for an extended period of time they die,”...
CPAPs and/or documentation requirements
April 23, 2010Theresa Flaherty, Managing Editor
There was a nugget of encouraging news at this week's MED Group Respiratory Summit in Jacksonville. There's a rumor floating around that CMS could take another look at its most recent set of rules for CPAP.
Patients who need an upgrade from a CPAP machine to a bi-level device must meet four--all four, the way it is written--of a set of metrics. That of course, must be documented by physicians.
"There is some movement to get CMS to (back away from this)," said Dan Brown, a healthcare attorney...