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indigosd

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Web has declined rapidly after the PEG- Button- Garden Hose fiasco. He has now lost the ability to blow his nose, increased drooling, suctioning is now a daily reality and he is c/o fatigue and weakness. Our Dr. will order the BiPap and the cough assist but NO ONE seems to know what we need or how we get Medicare to pay for it once they figure it out. Could someone give me a brand and model number of a Bipap with BACKUP and also a Cough Assist so that I can request that specific model? Does he have to do a sleep study? They said that we could do a home pulse ox? Will that be enough criteria to get him the equipment? WHAT IS THE MEDICARE CRITERIA FOR THE ABOVE? :confused:
Thank you. I spent about an hour using the search feature this morning on the forum but just ran out of patience. :-(
 
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I can't give you any information about Medicare because Serena's ins. payed for hers. When we where going to a Nerologist they insisted on a sleep study for her to get a bipap but when we swithced over to an ALS clinic they had one out the very next day. They set is on the lowest setting which has worked out well. We really like the model we have, it has a humidifier and we where able to hook up an oxygen bleed later on. I am at work right now so I can't give you the model number but I will pass it along as soon as I get home.

I am very sorry to hear of Web's decline. Hopefully the bipap will help. My very best and fondest wishes to you and Web.
 
Thank you Ken! What to do except roll over all the bumps in the road...
 
I would recommend BIPAP from Resperonics AVAPS. The AVAPS algorithm guarantees an average tidal volume by automatically adapting pressure support to meet the patient's needs on a breath-by-breath basis. You can ask your MD to order in home sleep study. There are a number of Home sleep study devices that could be set up by your local DME company.
Sorry I dont have much info on Cough Assist.
Best wishes to you,Erica
 
Erica, Thank you so much. I assume that I do a search for Resperonics AVAPS?
 
I have the Phillips Respironics System One BiPAP and the Phillips Respironics AVAPS. Both are from the VA so I can't speak to Medicare. Given a choice I would go with the AVAPS because it can do both BiPAP and volume. For setting the proper respiratory rate and volume he should have a sleep study but for the BiPAP they should be able to set it up now.
 
Kay Marie, call a medical supply company and they will be only to happy to tell you how to get these things through Medicare. This is how they make there money. Maybe the same place you got your suction machine? We got ours through a medical supply company rep who volunteers at our ALS clinic. We have a Respironics Cough Assist. HUGS Lori We did not have to have a sleep study done for our Resmed VPAP Adapt SV
 
I use the Respironics Syncrony ST. 5 years now. Original settings 16/6/16. Up to 20/10/18 now Numbers are IPAP/EPAP/BPM. Inspiration,Expiration and breaths per minute. An RT can set it up sometimes without a sleep study depending on Doc/state regs.

AL.
 
I love you guys soul much! BIG FAMILY HUG! I called Minnesota ALS and got a referral to a ANGEL Resp Therapist who recommended Respironics AND will work with our Dr. and the local DME so we can get one. :] She said, "You do not have to have a sleep study to qualify for Medicare to pay for BiPap-the diagnosed of ALS alng with ONE of the following: ABG'S a CO2 greater than 45, OR FVC less than 50% of Predicted value OR MIP less than 60 cm of water pressure." She said that it must be a BiPap with Backup and that Medicare will pay for both the face and the nasal pillow setup because most PALS will need both types. She also said that the sleep study was necessary only for sleep apnea and not for ALS. I called our DME and left a msg for them to call me so that I can then refer them to this Minnesota Angel. Why is everything just so fricking difficult?!
 
Hi there, I am sorry to hear about all the new things going on with Web sense the awful incident with his tube. Stress . I have not been as good sense I got mine. Getting better now after a month and a half. Don't think I will get back how I was before the tube. I got mine the same way Lori did. ... Hugs, L
 
Kay Marie,

My cough assist is by Respironics. I don't see a model number. Here is a picture of it, which may help you.

A respiratory therapist should be able to get Web the basic settings for the bipap, and a sleep study would fine tune it. The pressure when he exhales should be as low as possible, so he doesn't have to fight it to breathe. I have not been able to blow my nose with any velocity for some time now, and I'm really pretty healthy (within the scope of what we deal with) so don't worry too awfully much about that part. The cough assist is much more powerful than a suction machine, and, as a nurse, you probably already know that their uses are not interchangeable.

Mine are covered by Medicare, I pay a monthly co-pay to "rent" each device, After 13 months passed, Medicare required that I buy the bipap from the home health care that provided it. It was about 130$, but much nicer than the monthly co pay. The home healthcare company which provides the devices, took my medicare information, and submitted the documentation to Medicare for me, I've not had to deal with Medicare directly about either of them.

If I were you, I'd ask if the MDA or ALSA has a cough assist loaner.
 

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Rose, tussen takk! I have to tell you all that I am about POSTAL with frustration. I just finally got a return phone call from the DME in Aberdeen [waited all day] only to be told that they could not give us the equipment and that we would need to go to Sioux Falls [4 1/2 hours one way] or Fargo, ND [2 1/2 hours one way]. The reason they wouldn't is that they have no training in the equipment! I told the RT that the ALS RT in Minnesota would be more than happy to work with them but she was not even interested...grrrrrr So I guess that tomorrow will be spent calling north Dakota and praying that we can get it there. Isn't this just awful and STUPID. I can hardly wait until 9 PM so I can HOWL. Right now I am just making growling sounds...
 
KayMarie - have you checked the ALSA loan closet for either of these?

The company we originally "rented" the cough assist from would not budge on the financial need problem until we told them to go fly a kite and come pick it up! by then I was to peeved to deal with them anymore! So I called the ALSA and they had one in their closet. There is only one cough assist machine made as far as I know, unless someone has invented a new one in the last few months. It's a big o' thang! Don't expect it to be too portable. So what happened was ALSA brought it to the clinic and the RTs showed us how to use it (again).

As for the BiPap - at the clinic, my husband faked the FVC test in order to qualify per Medicare guidelines. We got the machine from a local DME company that has an RT. Emory just faxes the settings when he feels he needs them changed and the local DME RT comes out...no problem! (Hooray) We get the machine at no cost, since we qualify as "financially needy," or whatever they want to call it. Medicare pays their part and the company writes off the rest. The RT ( who happens to be part owner in the DME co. just had us fill out ONE form, with no documentation to back anything up. He said they just need that form if Medicare audits them.)

I really hope you can find a local company to supply these things! Or the ALSA or MDA!
 
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Sorry I did not get back to you yesterday but we had visitors when we got home, some good friends when had been trying to get together with for several weeks. Serena uses a Respironice BiPAP S/T Model 1014248 it sits in a REMstar heated humidfier. It is nice and compact and comes with it's own carring case so it's very portable. It's also very quiet.
 
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