Inhaled Meds

L

Landy

New member
I have asked this before, but wondered if anyone else is having issues with Medicare picking up coverage for inhaled meds lately? I take Xopenex & Pulmicort & the pharmacy said Medicare B would cover for COPD or emphysema, but not for CF (<img src="i/expressions/face-icon-small-mad.gif" border="0">don't <b>even</b> get me started on that one!!!).

I wondered if anyone else has experienced this? I assume this is a national thing, but am now wondering if it's just something in my state?

I thought that possibly others didn't notice this when I posted this before, (since this change was fairly new then), but are noticing it now.
Thanks!
 
L

Landy

New member
I have asked this before, but wondered if anyone else is having issues with Medicare picking up coverage for inhaled meds lately? I take Xopenex & Pulmicort & the pharmacy said Medicare B would cover for COPD or emphysema, but not for CF (<img src="i/expressions/face-icon-small-mad.gif" border="0">don't <b>even</b> get me started on that one!!!).

I wondered if anyone else has experienced this? I assume this is a national thing, but am now wondering if it's just something in my state?

I thought that possibly others didn't notice this when I posted this before, (since this change was fairly new then), but are noticing it now.
Thanks!
 
L

Landy

New member
I have asked this before, but wondered if anyone else is having issues with Medicare picking up coverage for inhaled meds lately? I take Xopenex & Pulmicort & the pharmacy said Medicare B would cover for COPD or emphysema, but not for CF (<img src="i/expressions/face-icon-small-mad.gif" border="0">don't <b>even</b> get me started on that one!!!).

I wondered if anyone else has experienced this? I assume this is a national thing, but am now wondering if it's just something in my state?

I thought that possibly others didn't notice this when I posted this before, (since this change was fairly new then), but are noticing it now.
Thanks!
 
L

Landy

New member
I have asked this before, but wondered if anyone else is having issues with Medicare picking up coverage for inhaled meds lately? I take Xopenex & Pulmicort & the pharmacy said Medicare B would cover for COPD or emphysema, but not for CF (<img src="i/expressions/face-icon-small-mad.gif" border="0">don't <b>even</b> get me started on that one!!!).

I wondered if anyone else has experienced this? I assume this is a national thing, but am now wondering if it's just something in my state?

I thought that possibly others didn't notice this when I posted this before, (since this change was fairly new then), but are noticing it now.
Thanks!
 
L

Landy

New member
I have asked this before, but wondered if anyone else is having issues with Medicare picking up coverage for inhaled meds lately? I take Xopenex & Pulmicort & the pharmacy said Medicare B would cover for COPD or emphysema, but not for CF (<img src="i/expressions/face-icon-small-mad.gif" border="0">don't <b>even</b> get me started on that one!!!).
<br />
<br />I wondered if anyone else has experienced this? I assume this is a national thing, but am now wondering if it's just something in my state?
<br />
<br />I thought that possibly others didn't notice this when I posted this before, (since this change was fairly new then), but are noticing it now.
<br />Thanks!
 
S

Skye

New member
Landy....someone please correct me if I am wrong. I would think that COPD is a rather generic description of many things that affect lung function ie smoking, age, aspiration pneumonia. Anyway....usually half of my elderly patients when I worked in a nursing home had a COPD diagnosis. That being said....I don't know why CF would not be categorized under the "umbrella" of a COPD definition. I seem to recall even my own pulmonologist referring to my lung function tests as indicating moderate COPD. The acronym is chronic obstructive pulmonary disease......that defines CF. Soooo....what does your doctor or CF team say about these denials? Maybe you have an idiot looking at your file and not understanding what should be covered. I would think your social worker would be able to help you fight this issue. Maybe a letter from your doctor would help. I hope others post.
 
S

Skye

New member
Landy....someone please correct me if I am wrong. I would think that COPD is a rather generic description of many things that affect lung function ie smoking, age, aspiration pneumonia. Anyway....usually half of my elderly patients when I worked in a nursing home had a COPD diagnosis. That being said....I don't know why CF would not be categorized under the "umbrella" of a COPD definition. I seem to recall even my own pulmonologist referring to my lung function tests as indicating moderate COPD. The acronym is chronic obstructive pulmonary disease......that defines CF. Soooo....what does your doctor or CF team say about these denials? Maybe you have an idiot looking at your file and not understanding what should be covered. I would think your social worker would be able to help you fight this issue. Maybe a letter from your doctor would help. I hope others post.
 
S

Skye

New member
Landy....someone please correct me if I am wrong. I would think that COPD is a rather generic description of many things that affect lung function ie smoking, age, aspiration pneumonia. Anyway....usually half of my elderly patients when I worked in a nursing home had a COPD diagnosis. That being said....I don't know why CF would not be categorized under the "umbrella" of a COPD definition. I seem to recall even my own pulmonologist referring to my lung function tests as indicating moderate COPD. The acronym is chronic obstructive pulmonary disease......that defines CF. Soooo....what does your doctor or CF team say about these denials? Maybe you have an idiot looking at your file and not understanding what should be covered. I would think your social worker would be able to help you fight this issue. Maybe a letter from your doctor would help. I hope others post.
 
S

Skye

New member
Landy....someone please correct me if I am wrong. I would think that COPD is a rather generic description of many things that affect lung function ie smoking, age, aspiration pneumonia. Anyway....usually half of my elderly patients when I worked in a nursing home had a COPD diagnosis. That being said....I don't know why CF would not be categorized under the "umbrella" of a COPD definition. I seem to recall even my own pulmonologist referring to my lung function tests as indicating moderate COPD. The acronym is chronic obstructive pulmonary disease......that defines CF. Soooo....what does your doctor or CF team say about these denials? Maybe you have an idiot looking at your file and not understanding what should be covered. I would think your social worker would be able to help you fight this issue. Maybe a letter from your doctor would help. I hope others post.
 
S

Skye

New member
Landy....someone please correct me if I am wrong. I would think that COPD is a rather generic description of many things that affect lung function ie smoking, age, aspiration pneumonia. Anyway....usually half of my elderly patients when I worked in a nursing home had a COPD diagnosis. That being said....I don't know why CF would not be categorized under the "umbrella" of a COPD definition. I seem to recall even my own pulmonologist referring to my lung function tests as indicating moderate COPD. The acronym is chronic obstructive pulmonary disease......that defines CF. Soooo....what does your doctor or CF team say about these denials? Maybe you have an idiot looking at your file and not understanding what should be covered. I would think your social worker would be able to help you fight this issue. Maybe a letter from your doctor would help. I hope others post.
 
J

JazzysMom

New member
Skye....

COPD has its own dx code & unless it is used in adjacent with the CF dx code it doesnt work the way you would think......

It seems logical that it should be included, but its all in the coding. Just like with CF having different codes according to the issue (CF exacerbation versus just CF) etc.
 
J

JazzysMom

New member
Skye....

COPD has its own dx code & unless it is used in adjacent with the CF dx code it doesnt work the way you would think......

It seems logical that it should be included, but its all in the coding. Just like with CF having different codes according to the issue (CF exacerbation versus just CF) etc.
 
J

JazzysMom

New member
Skye....

COPD has its own dx code & unless it is used in adjacent with the CF dx code it doesnt work the way you would think......

It seems logical that it should be included, but its all in the coding. Just like with CF having different codes according to the issue (CF exacerbation versus just CF) etc.
 
J

JazzysMom

New member
Skye....

COPD has its own dx code & unless it is used in adjacent with the CF dx code it doesnt work the way you would think......

It seems logical that it should be included, but its all in the coding. Just like with CF having different codes according to the issue (CF exacerbation versus just CF) etc.
 
J

JazzysMom

New member
Skye....
<br />
<br />COPD has its own dx code & unless it is used in adjacent with the CF dx code it doesnt work the way you would think......
<br />
<br />It seems logical that it should be included, but its all in the coding. Just like with CF having different codes according to the issue (CF exacerbation versus just CF) etc.
 
L

Landy

New member
Oh, I asked my doctors office if I was similar enough to COPD to have that diagnosis code for the script, but they refused because I "don't have COPD".
 
L

Landy

New member
Oh, I asked my doctors office if I was similar enough to COPD to have that diagnosis code for the script, but they refused because I "don't have COPD".
 
L

Landy

New member
Oh, I asked my doctors office if I was similar enough to COPD to have that diagnosis code for the script, but they refused because I "don't have COPD".
 
L

Landy

New member
Oh, I asked my doctors office if I was similar enough to COPD to have that diagnosis code for the script, but they refused because I "don't have COPD".
 
L

Landy

New member
Oh, I asked my doctors office if I was similar enough to COPD to have that diagnosis code for the script, but they refused because I "don't have COPD".
<br />
 
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