Item Brochure

DeVilbiss Healthcare LLC 100 DeVilbiss Drive Somerset, PA 15501 USA
800.338.1988 814.443.4881 www.DeVilbissHealthcare.com
© 2012 DeVilbiss Healthcare LLC. 03.12 All Rights Reserved.
DeVilbiss
®
is a registered trademark of DeVilbiss Healthcare. Hybrid
®
is a registered trademark of RespCare, Inc. LT-2017 Rev C
• 100% latex free
• One package contains all of the components
required to properly size the patient,
eliminating the hassle and waste of opening
multiple products to properly fit the patient
• Universal design simplifies choice and fitting
protocols and minimizes time spent with a
patient to address issues such as mouth
breathing or claustrophobia
• Adjustable nasal pillow design provides a
customized fit for each patient
• No nasal bridge or forehead contact eliminates
nasal bridge sores and air leaks near eyes
• Swivel tubing coupler to accommodate free
movement and optimal performance during
the night
• Supplemental oxygen ports
• Patient Instructional DVD and carrying case
included with each complete system
• To view video, please visit:
http://www.hybridmask.com
Design Features
Accessories and Replacement Parts
Reimbursement Information
Product Description Code Description HCPCS Coding Frequency
Allowable
Range
HYBRID MASK
((HYB500)
HYBRID ORAL
CUSHION
(HYB511, HYB513, HYB515)
HYBRID NASAL
PILLOW
(HYB521, HYB523, HYB525)
HYBRID HEADGEAR
(HYB530)
Combination oral/nasal mask, used
with continuous positive airway
pressure device.
each
Oral cushion for combination
oral/nasal mask, replacement only.
each
Nasal pillows for combination
oral/nasal, replacement only.
pair
Headgear
A7027
A7028
A7029
A7035
1 every 3
months
2 pairs
per month
2 pairs
per month
One per
6 months
$170.30-$200.35
$45.24 -$53.22
$18.48 -$21.74
$31.27 - $36.79
PART PRODUCT
NUMBER DESCRIPTION
HYB500 Hybrid Interface Complete System*
HYB515 Hybrid Interface Oral Cushion Large
HYB513 Hybrid Interface Oral Cushion Medium
HYB511 Hybrid Interface Oral Cushion Small
* Includes small, medium, large oral cushions, small, medium large nasl pillows and headgear.
PART PRODUCT
NUMBER DESCRIPTION
HYB530 Hybrid Interface Headgear
HYB525 Hybrid Interface Nasal Pillows Large
HYB523 Hybrid Interface Nasal Pillows Medium
HYB521 Hybrid Interface Nasal Pillows Small
The noted allowable rates are based off of the January 2012 HCPCS Fee Schedule. All information presented is for reference purposes only.