Skip to Main Content
 
 
 
Web Content Viewer

Policy Education Topics

Web Content Viewer
Web Content Viewer

Continuous (CPAP) Devices/Bi-Level Devices

Suppliers receive ANSI code CO-16 (claim lacks information which is needed for adjudication) when a claim is submitted for a new capped rental period when the beneficiary switches from a CPAP device (E0601) to a bi-level device (E0470–E0472).

A new capped rental period will begin when the physician orders the beneficiary to switch from a CPAP device to a bi-level device and the coverage criteria for the bi-level device are met. Suppliers must submit the initial month’s claim for the bi-level (E0470–E0472) device with the RRKH modifier indicating a new capped rental period.

If the beneficiary switches from a bi-level device to a CPAP device, a new capped rental period will not begin. The previous capped rental period for the bi-level device will resume where it left off prior to the change in equipment. Suppliers must append the RR modifier and the appropriate monthly modifier (KI or KJ) to the claim.

Use the IVR system to determine the appropriate monthly modifier to append. Contact the IVR at 877-299-7900.

Effective immediately, you must resubmit return/rejected CO-16 claims for beneficiaries that were initially on a CPAP device and switched to a bi-level device with the appropriate modifier.

Continuous (CPAP) Devices/Bi-Level Devices
Web Content Viewer
Web Content Viewer
Complementary Content