Getting a BIPAP/NIV

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GXTrex

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It appears it is time for my dad to start using a NIV, at least at night. He is sleeping more during the day, and his breathing seems loud at rest. We have a virtual clinic appointment next week. Would they be able to get him one via Medicare without going in person?

This appointment is virtual because we do not have a wheelchair ramp installed yet, and we want to wait for the weather to warm up before making the trip so it's easier on him. Our plan is an in person clinic in March. Any advice?
 

lgelb

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Yes, they can. if he has recent PFTs. If not, that may depend on his (traditional? Advantage?) plan, state, etc. I am not sure if all the waivers that began in 2020 are still active. His clinic is the place to ask.
 

GXTrex

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@lgelb
PFTs? What do you mean?
He has traditional Medicare in New York.
 

lgelb

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Pulmonary function tests. The Medicare criteria for reimbursing a BiPAP are FVC<50% of predicted and/or MIP<60 cm.

There may be a waiver of those criteria in effect at this point because of Covid -- that's what I meant about asking the clinic.

If in-person testing is required but he can't get out, you can also get any doc to write an rx given his ALS, and pay cash online for a new or refurbed BiPAP (any machine with a volume control mode like iVAPS, AVAPS and preferably a backup rate), then use that as a backup machine if you end up with a Trilogy or Astral. I often recommend Second Wind for that purpose.
 
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krnNdug

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Our Clinic has had many bipap machines. We have to get the replacement hosing through our DME provider.

Our chapter also has loaner ramps. We needed a second, longer ramp and we found an 8 foot ramp that separates and folds.

A boy scout troop who had an eagle candidate who needed to plan and implement a service project. They not only measured and built one for our front door, but they also built one for the back door. They also made cookies and brought donuts and coffee for all of our neighbors.

It was great being able to help a young man attain a goal and at the same time we got 2 custom ramps and I added a couple of pounds. My ALS doctor is a proponent to keep as much weight on. That's an Rx for dessert 👍
 
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