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July 2015

Clarification: Blue Cross’ CPAP device replacement policy

In the May 2015 issue of The Record, we wrote that continuous positive airway pressure devices can be replaced every five years. While this is true for our Medicare Advantage products, the policy for Blue Cross commercial products states that a CPAP device can be replaced every three years under the following conditions: 

  • After three years of reasonable use
  • During the three-year reasonable-use period if a replacement is needed and the device warranty has expired

For more information on CPAP benefit guidelines and billing, refer to your provider manual.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2014 American Medical Association. All rights reserved.
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