Medicare’s PDAC (Pricing, Data Analysis and Coding) has notified Naturs Design Inc that its RemZzzs CPAP Mask Liners will no longer be eligible for reimbursement coverage under Medicare.
The PDAC revised RemZzzs HCPCS Medicare billing codes A7031 and A7032 (which are coverable) to A9270, a non-covered item.
In a statement to Naturs Design Inc, the PDAC stated that it considers the function of the RemZzzs liners to be “duplicative” to existing mask functions, according to the company.
“CPAP masks are equipped with an interface material to make the seal around the area of the face, in order for the mask to function properly. Additional CPAP mask liners are considered duplicative of what is already provided on the mask. Therefore, this is assigned coded A9270,” the PDAC wrote, according to materials provided by RemZzzs and Sleep Solutions Home Medical.
RemZzzs said the notion that its mask liners were duplicative “hardly seems likely.”
“Billing on the A7031 and A7032 interface codes does not incur extra cost for Medicare. In fact, RemZzzs CPAP mask liners … have been successfully billed by hundreds of DME/HME customers in addition to raising compliance numbers for thousands of PAP users,” the company said in an e-mail.
In an effort to restore its HCPCS code coverage, RemZzzs is asking sleep physicians and professionals to submit testimonials to the PDAC that demonstrate the positive effects that the CPAP mask liners have had on their patients’ sleep disorders.