[ChelseaCare]

For Medicare, what is the proper HCPCS and modifier combination to bill for CPAP repair? (for both the labor and parts)

Thanks in advance for your input!

[Kristin]

We just recently started billing for CPAP repair, I used K0739 (1 unit=15 min of labor) and I use A9999 for parts with a narrative description and RB modifier.

[ChelseaCare]

Did you get paid yet, Kristin?

[Kristin]

Yes they allowed all lines, I submitted 4 lines for A9999, and one labor line.

[huddleston2003]

What happens when a CPAP patient has had her equipment for about 3-4 years and the warranty is up and the estimate for repair from the manufacturer is about $400.00? Is there any way to get this covered by Medicare or is this just the patient's responsibility to cover repair?

Thanks!
Amber Huddleston
Homeside Healthcare, Inc.
606-563-9400

[Kristin]

You should be able to bill for the parts and labor that the manufacturer is charging you to repair the equipment. As long as repairing the equipment is cheaper than replacing it Medicare should pay.