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UARS Dx
Recently my DME has recieved a few Rx's with the Dx as UARS with hypersomulence. It is my understanding that UARS is not a qualifying Dx for CPAP by Medicare. Am I wrong? I can not find any verbage in the Medicare LCD or NCD stating if there was any exceptions.
Does anyone know of a route around this? Or am I stuck with telling a patient she will have to pay out of pocket for her CPAP and supplies if she wants to fill the doctors Rx?
Does anyone know of a route around this? Or am I stuck with telling a patient she will have to pay out of pocket for her CPAP and supplies if she wants to fill the doctors Rx?
Views: 50
Replies to This Discussion
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Permalink Reply by D. W. Conn on
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Medicare will in cases of UARS and hypersomnolence with the presences of snoring allow nPAP. Medicaid however will not. It all depends on the how it is reported.
She may request the Physician to rescore the study. There are so many variables and too many to go into here on the forum. Talk to Medicare and the Physician.
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