Standards of Practice Committee of the American Sleep Disorders Association. Filters, which need to be replaced frequently, run between $5 and $30 each. endobj Information on this website should not be construed as medical advice. BCBS of Kansas, which covers approximately 560,000 members.. An independent member of the Blue Shield Association 2.01.18 Diagnosis of Obstructive Sleep Apnea Syndrome Original Policy Date: April 3, 2009 Effective Date: October 1, 2022 Section: 2.0 Medicine Page: Page 1 of 26 . MPTAC review. Marino M, Li Y, Rueschman MN, et al. 2004; 8(3):611-630. Be aware that if you decide to stop CPAP treatment and decide later that you want to try the treatment again, your insurance company may require you to re-qualify for coverage. BCBSNC will provide coverage for Diagnosis and Medical Management of Sleep Apnea when it is determined to be medically necessary because the medical criteria and guidelines shown below are met. This revised Medical Policy will apply to both professional provider and facility claims. Compliance monitoring equipment for CPAPs, APAPs, or BiPAPs (e.g., smart card, compliance chip, tele monitoring, and computer software) is considered an integral component of the function of the device and is not eligible for separate reimbursement. For the purposes of this document, the terms AHI and RDI are interchangeable, although they may differ slightly in clinical use. 2007; 1:1-8. BiPAP machines, which provide a different level of air pressure for exhalation and inhalation, frequently run in the thousands of dollars. BCBS of Kansas City, March 1, 2019 . Conley S, Knies A, Batten J, et al. Coveredsleep apneaDiagnosis Codes for Procedure Code E0601, Non-Covered Diagnosis Codes for Procedure Code E0471. A7027. 2023 Blue Cross Blue Shield of North Dakota, Please wait while your form is being submitted, Devices Used for the Treatment of Sleep Apnea in Adults, A positive airway pressure device (CPAP, BPAP-ST,) may be considered medically necessary for the first three (3) months of therapy for those individuals with central sleep apnea (CSA) that have had an attended polysomnogram, performed on stationary equipment. Payment will be made for the purchase of the device when Adherence to therapy is defined as use of PAP greater than or equal to four (4) hours per night on 70% of nights during a consecutive 30-day period anytime during the first three (3) months of initial usage. Doctors can test for sleep apnea with an overnight in-lab sleep study, also called a polysomnography, or with an at-home sleep study. Only 10% allow for more frequent replacement. However, this information is provided without warranty. If you require more frequent replacements of certain components, those costs may be out of pocket. Your doctor will first check for symptoms of obstructive sleep apnea, including: If your symptoms indicate you might have obstructive sleep apnea, the next step is to take a sleep study. Medically necessary criteria regarding Type III home portable devices were updated with information about newer models of the SNAP devices that are considered Type III devices. Addition of acoustic pharyngometry to the testing considered investigational/not medically necessary. Revision based on Harmonization: Pre-merger Anthem and Pre-merger WellPoint. Annals Intern Med. 2012; 130(3):576-584. Premera Blue Cross, the largest health plan in the Pacific Northwest covering over 2.1 million members in Washington and Alaska. So if you're close to meeting your deductible, you may be able to acquire your CPAP device at almost no cost to you. NCD #240.4.1. Keep in mind that whether or not you use insurance, medical equipment sellers require a CPAP prescription in order for you to purchase the machine and equipment. 2003, 24(2):307-313. O'Driscoll DM, Foster AM, Davey MJ, et al. The application of each Blue Shield of California medical policy is subject to regulatory requirements and/or plan specific benefits and limitations (Evidence of Coverage - EOC). Available at: Kirk V, Baughn J, D'Andrea L, et al. Everyone's insurance plan is different. Danny is a Certified Sleep Science Coach with an in-depth knowledge of sleep health. If youve been diagnosed with sleep apnea, its likely that youll need a CPAP mask, as this is considered the best course of treatment for the condition. Effective March 3, 2009. First, your doctor must diagnose you with obstructive sleep apnea following an approved laboratory sleep study or an at-home sleep study, and give you a prescription for a CPAP machine. With Original Medicare coverage, you pay 20% of the machine rental plus the cost of supplies such as the CPAP mask and tubing. Be sure to check your insurance policy to determine your specific requirements. Most machines record your use for you. These coverage types are separate from one another. It happens when the muscles in the throat relax and block the air passages to make sure . Replacements of PAP devices for members with an existing diagnosis of OSA do not need a compliance chip if documentation of previous compliance, (i.e., compliance chip, telemonitoring, computer software), has been confirmed in the medical record. Clinical practice. Required fields are marked *. Go to www.providerportal.com Note: If you've already registered for the ProviderPortal for Blue Cross Blue Shield of Massachusetts or another insurer, you won't need to register again. A clarification was made within the Definitions section regarding severe OSA as being defined as an RDI/AHI of greater than 30 (not 40). The necessary doctors appointments and sleep studies come with their own costs, depending on your insurance plan and associated deductible. Report of the Swiss respiratory polygraphy registry and systematic review of the literature. Upper airway: The area of the upper respiratory system including the nose, mouth and throat. State Medicaid programs typically follow the same guidelines as Medicare. A trial with CPAP has failed or is contraindicated; The device is prescribed by a treating physician; The device is custom-fitted by qualified dental personnel; There is absence of temporomandibular dysfunction or periodontal disease. Sleep disorder studies are used to determine or confirm a diagnosis related to sleep disturbances. There is no additional payment for liners used with a PAP mask. For general information about AIM Specialty Health, call 1-847-564-8500, Monday through Friday, from 9 a.m. to 6 p.m., Eastern Time (ET). AHRQ Technology Assessment Program. Guidelines are designed to support the decision-making processes in patient care. Updated Coding section with 01/01/2009 CPT changes; removed 0089T deleted 12/31/2008. This condition is also defined as a score greater than or equal to 10 on the Epworth Sleepiness Scale. Watanabe T, Kumano-Go T, Suganuma N, et al. Available at: Journal of the American Medical Association. <> 1. Call the National Information Center at 1-800-411-BLUE (2583)weekdays from 8 a.m. to 8 p.m. Eastern time. MPTAC review. MPTAC review. These policies may be updated from time to time, so always check with your insurance provider for the most up-to-date information. - Power Supplies: CPAP Power Cords and Batteries. Updated coding: Added CPT code 95806 and 0089T; removed CPT codes 21193, 21194, 21195, 21196, 21198, 21199, 21206, 21685, 42145, 95806, 95808, 95810, 95811, 99508; removed ICD-9 Procedure codes 76.62, 76.63, 76.64, 76.65, 76.66, 89.17; removed HCPCS codes E0561, E0562, E0601, K0183, K0189, K0268, K0531, K0532, K0533, S8260, D7940, D7944, D7946, D7947, D7948, D7949, D7950, D7950, D7995, D7996, S2080, 0088T. Measuring sleep: accuracy, sensitivity, and specificity of wrist actigraphy compared to polysomnography. Smith MM, McCrae CC, Cheung JJ, et al. Your daily habits and environment can significantly impact the quality of your sleep. In order to give you a prescription for a CPAP machine, your doctor must confirm that your sleep difficulties are caused by sleep apnea and not by another condition. More than five (5) apneas, hypopneas, or RERAs per hour of sleep (i.e., an AHI or RDI greater than five (5) events per hour) in an individual with symptoms (e.g., sleepiness, fatigue and inattention), or signs of disturbed sleep (e.g., snoring, restless sleep, and respiratory pauses). MPTAC review. If your CPAP prescription mentions a Lifetime Need or says 99 months, this means that the prescription is valid for as long as you require the therapy. 2007; 146(3):157-166. The document header wording was updated from Current Effective Date to Publish Date. References were updated. Fargo, N.D., 58121. Bi-level Positive Airway Pressure(BiPAP) without back-up rate. Marcus CL, Brooks LJ, Draper KA, et al. However, none of these portable tests currently provide diagnostic information that is superior to established Type III home portable monitors (HPM), which monitor and record a minimum of four parameters: respiratory movement/effort, airflow, ECG/heart rate, and oxygen saturation. Seen as youll need a CPAP prescription from your doctor in order to make an insurance claim, you may be wondering how long your prescription is valid for. Werner H, Molinari L, Guyer C, Jenni OG. Med Clin North Am. PAP (positive airway pressure) Machines and Humidifiers, Typically, filter replacements are every 30 days, Typically, tubing replacements are every 3 months, Typically, mask replacements are every 3 months, 3-month rental, 4th-month purchase (many PPO insurances), 10-month rental (most HMO insurance and some PPO insurances), 13-month rental (Medicare and other government insurance). Agency for Healthcare Research and Quality (AHRQ), Rockville, MD; August 8, 2007. More than 75% of the apneas or hypopneas must have an obstructive pattern. Insurance providers typically take your apnea-hypopnea index (AHI) into consideration when determining your eligibility for CPAP therapy coverage. The machine is returned to the doctor the following morning for data analysis. <>/Font<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Please refer to the members contract benefits in effect at the time of service to determine coverage or non-coverage of these services as it applies to an individual member. An American Academy of Sleep Medicine Report. Diagnosis and management of childhood obstructive sleep apnea syndrome. Paying for your equipment directly gives you the opportunity to compare products and choose the CPAP equipment you find most suitable. Oct 1, 2020 Administrative. 3 results found for search term : sleep apnea Hypertension Programs and resources to help you prevent and manage hypertension. 3 0 obj American Academy of Sleep Medicine; Standards of Practice Committee. Please reference the Sleep Disorder Management order entry worksheets before submitting your request. Because CPAP machines and their tubing are required daily, theyre subject to significant wear and tear, so you may be wondering how often insurance will cover CPAP supplies. You might be able to find direct-to-supplier CPAP manufacturers with lower prices than those available through your insurance plan, though be sure to check if these devices are approved by the FDA. Effective April 01, 2023. Many insurance providers require you to meet your annual deductible before covering your CPAP equipment. The indications for polysomnography and related procedures. - Any additional medical records, such as your sleep study, that your insurance company requests. 2002; 165(11):1499-1503. MPTAC review. Littner M, Hirshkowitz M, Kramer M, et al. Most insurance plans offer partial coverage for CPAP machines once you meet your deductible. Added reference for Centers for Medicare and Medicaid Services (CMS) National Coverage Determination (NCD). See the table below for the usual maximum amount of accessories considered to be medically necessary. 2007; 16(2):213-216. for the American Academy of Sleep Medicine. The appropriate setting for standard CPAP treatment is determined during a titration sleep study. These Medical Policies serve as guidelines for health care benefit coverage decisions, which may vary according to the different products and benefit plans offered by BCBSIL. Well cover some of the most common insurance policies surrounding CPAP equipment. Then, Medicare covers a 12-week initial period of CPAP therapy for obstructive sleep apnea, as long as you meet the following requirements: You must also meet Medicares compliance requirements, which state that you must use the machine at least 4 hours per night, 70% of the time or more, during the first 3 months. Yavuz-Kodat E, Reynaud E, Geoffray MM, et al. CSA results from the brain's inability to send appropriate signals to the respiratory muscles to stimulate breathing. Once the 13 months have passed, you own the machine. Five more Blue Cross Blue Shield health plans have extended coverage to Inspire Medical Systems' (NYSE: INSP) sleep apnea therapy, the company said today. Your AHI must also meet the same requirements as for Medicare: If you meet these requirements, then Medicaid provides CPAP coverage for a 12-week trial. However, if the member is found to be using the PAP device as directed and is achieving the desired results, the DME supplier must contact the individual's physician near the end of the rental period and ask the doctor to prescribe the purchase of the device. An evidence review cosponsored by the American Academy of Sleep Medicine, the American College of Chest Physicians, and the American Thoracic Society. This difference in efficacy is more pronounced for individuals with severe OSA, as oral appliances have been shown to be less efficacious in individuals with severe OSA than they are in individuals with mild-moderate OSA. Epworth sleepiness scale (ESS): A standardized measure of the degree of sleepiness. This document addresses selected services for the diagnosis of sleep disorders including: Investigational and Not Medically Necessary: Nap studies are considered investigational and not medically necessary either for screening purposes or as an alternative to polysomnography for the diagnosis of obstructive sleep apnea or narcolepsy. If you fail to meet these requirements, you have to begin the process again. Directory Validation Instructions (No Surprises Act), Recredentialing & Credentialing Applications. People with obstructive sleep apnea experience partial or complete closure of the upper airway during sleep, which can lead to snoring, gasping, or even choking. Sleep disorders are some of the most common medical problems in the United States and have a significant impact on quality of life (QOL), productivity, and overall health. On the other hand, if you have a co-insurance plan, you will also be billed monthly for the rental cost of the device, alongside your insurance company. endobj First, you must have a prescription for CPAP therapy from your healthcare provider. Payment may be made for one (1) appliance. Obstructive sleep apnea (OSA): This is a form of sleep disturbance, which occurs as the result of a physical occlusion of the upper airway during sleep, which interferes with normal breathing. Sleep. x%xuY2dpVcE/@ah7F]UdjEfd?GD?gg_|?\g_vwV.{5Zn||6H3htwME#r7KG=.w.LrGK!gC$Z:UwcrYAR#Oc1e w|nl8.4qg2JAS]z7=H#{AYkt=C^zEg1fn). However, youre probably wondering about insurance. CardioMEMSHeart Failure (HF) System coverage criteria has been relocated from If you have any questions about the guidelines, or wish to provide feedback, this can be done by contacting the Quality Improvement Department at 312-653-3465. Five (5) events per hour of sleep in a symptomatic individual (e.g., sleepiness, fatigue and inattention); Signs of disturbed sleep (e.g., snoring, restless sleep, and respiratory pauses) and. Liners are products placed between the individuals skin and the PAP mask interface and are made of cloth, silicone or other materials. These tests include, but are not limited, to: nap studies, actigraphy, diagnostic audio-taping, topographic brain mapping, and acoustic pharyngometry. 2 0 obj Medicaid and Medicare partially cover CPAP machines for all three AHI indexes, provided you meet certain conditions. Blue Cross and Blue Shield Kansas is an independent licensee of the Blue Cross Blue Shield Association Contains Public Information Populations Interventions Comparators Outcomes Individuals: With suspected obstructive sleep apnea Interventions of interest are: Limited channel home sleep apnea testing Comparators of interest are: Other insurance providers may have different standards. If you're ready for more, sign up to receive our email newsletter! <> 2003, 26(7):907-913. However, if the member is found to be using the PAP device as directed and is achieving the desired results, the DME supplier must contact the individuals physician near the end of the rental period and ask the doctor to prescribe the purchase of the device. Sleep. Our site does not include the entire universe of available offers. Recommendations from other national entities may vary. Validity of actigraphy compared to polysomnography for sleep assessment in children with autism spectrum disorder. MPTAC review. CPAP therapy is effective, but it can also be expensive. This is a unique virtual learning experience for health care professionals caring for women and . - Travel CPAPs: Insurance will not cover a second accessory CPAP for travel. Medical and surgical treatments for obstructive sleep apnea syndrome are in benefit. Can actigraphy measure sleep fragmentation in children? dX*[D #M:KX{JyIq+R!Iw?p v~pg|A~2vcDTXu9wkZ.fr2{uI)=8y_a{?Et-. 2020; 172(5):325-336. Medical Policy & Technology Assessment Committee (MPTAC) review. You also avoid the insurance requirements of treatment compliance. 1996; 11(2). The current body of evidence supporting the use of actigraphy for individuals with sleep disorders is insufficient to allow adequate conclusions regarding efficacy. No. The following diagnostic tests are considered investigational and not medically necessary: The evidence in the medical literature does not support the use of single nap studies. A CPAP (continuous positive airway pressure) machine sits next to your bed as you sleep. A replacement cushion/pillow is not billable when supplying an ongoing replacement of the frame with cushion/pillow. Sleep. Usually, your insurance company will cover the cost of your CPAP or bi-level PAP device. Removed ICD-9 codes from Coding section. Agreement rates between actigraphy, diary, and questionnaire for children's sleep patterns. endobj Arch Pediatr Adolesc Med. Neurol Clin. While these are the most common prescription and compliance requirements for CPAP coverage, each provider has its own specific rules. Common warning signs include snoring and excessive daytime sleepiness (Kryger, 1997). SleepFoundation.org is not affiliated with the National Sleep Foundation, an independent nonprofit based in Washington, DC. Payment will be made for the rental of a PAP device for the first three (3) months (rental period) from the original start date of therapy, when the above clinical criteria are met. Centers for Medicare and Medicaid Services. But don't worry - our team will handle the legwork in getting them to your insurance company. American Academy of Sleep Medicine. Home diagnosis of sleep apnea: a systematic review of the literature. Regardless of utilization, a supplier must not dispense more than a three (3) month quantity at a time. Sleep Diag Ther. Available at: Berry RB, Quan SF, Abreu AR, et al. Netzer NC, Stoohs RA, Netzer CM, et al. (such as sleep studies, CT scans) . According to SoClean CEO Bob Wilkins, there are roughly 8 million CPAP users in the United States, and this is growing yearly. Treatment of Obstructive Sleep Apnea Procedure code: E0601 Background: Sleep Apnea Sleep apnea occurs when an adult stops breathing or has slowed breathing during sleep. Updated the formatting of the Position Statement section. J Clin Sleep Med. 2004; 291(16):2013-2016. Thankfully, the majority of Anthem Blue Cross Blue Shield PPO and HMO plans cover CPAP therapy supplies. The Blue Cross Obstructive Sleep Apnea in Children The presentation of OSA in children may differ from that of adults. Current medical policy is to be used in determining a Member's contract benefits on the date that services are rendered. A positive airway pressure device (CPAP, BPAP-ST,) may be considered medically necessary for the first three (3) months of therapy for those individuals with central sleep apnea (CSA) that have had an attended polysomnogram, performed on stationary equipment and meet ALL of the following criteria: Intraoral appliances (tongue-retaining devices or mandibular advancing/positioning devices) may be considered medically necessary in adult individuals with OSA when ALL of the following criteria are met: Intra-oral devices not meeting the criteria as indicated in this policy are considered not medically necessary. 4 0 obj The following codes for treatments and procedures applicable to this document are included below for informational purposes. Individuals have confirmed diagnosis of OSA (confirmed via a positive facility-based PSG or with a positive home/portable sleep test); AHI greater than or equal to 15 events per hour of sleep in an asymptomatic individual. The two main types of sleep apnea are: In addition, studies have suggested that acoustic pharyngometry may be useful in identifying sites of airway narrowing. Oral cushion for combination oral/nasal mask, replacement only, each. Medical technology is constantly evolving, and we reserve the right to review and update Medical Policy periodically. Benefits Application This medical policy relates only to the services or supplies described herein. Continued use beyond the first three (3) months of therapy Dise Is A Prerequisite To Inspire In order to prove your eligibility for coverage of your CPAP device, Anthem Blue Cross will require documentation such as relevant doctors notes, sleep test results, a prescription, and may include other documents, too. 2002; 109(4):e69. Sleep. Members must consult their applicable benefit plans or contact a Member Services representative for specific coverage information. Likewise, medical policy, which addresses the issue(s) in any specific case, should be considered before utilizing medical opinion in adjudication. CPAP devices are usually covered by your insurance company on a monthly rental basis, over a period of approximately 3 to 10 months. The criteria for home portable monitors/sleep testing have been removed from this document and placed in CG-MED-01 Polysomnography and Home Portable Monitors. Policy and Coverage Criteria for Commercial Products: The AIM Clinical Appropriateness Guidelines include medical necessity criteria for Sleep Disorder Management: % Sleep. The occlusion is usually in the back of the tongue and/or flabby tissue in the upper airway. Validation of actigraphy for determining sleep and wake in children with sleep disordered breathing. 2004; 130(1):58-66. If youre among the 2% to 9% of adults who suffer from obstructive sleep apnea, a CPAP machine may be the solution to better sleep. Sleep disorder: A disruptive pattern of sleep that may include difficulty falling or staying asleep, falling asleep at inappropriate times, excessive total sleep time, or abnormal behaviors associated with sleep. Flemons WW, Littner MR, Rowley JA, et al. Episodes often result in reductions in blood oxygen saturation and are usually terminated by brief arousals from sleep. Device expenses incurred during the first three (3) months of rental will be applied to the purchase price. Insurance plans can significantly help defray the cost of a CPAP machine. Available at: Thurnheer R, Bloch KE, Laube I, et al. You must decide if you prefer to pay the full cost of the monthly rental, purchase the machine outright, or stop CPAP treatment altogether. Blue Cross Blue Shield North Carolina does cover weight loss surgery, but your specific policy must include it in order for you get it covered. This eliminates the possibility of needing to return your machine and restart the process of getting a sleep test and prescription from your doctor. Device expenses incurred during the first three (3) months of rental will be applied to the purchase price. That said, coverage varies depending on your plan, insurance company, and authorization requirements. If there are continued obstructive respiratory events at 15 cm H2O of CPAP during the titration study, the individual may be switched to BiPAP; For whom BiPAP is found to be more effective in the sleep lab. 4510 13th Ave. S. Central Sleep Apnea (CSA) is a serious breathing disorder that disrupts the normal breathing pattern during sleep and negatively affects quality of life and overall cardiovascular health. The medical records must also document objective findings of compliance information, (i.e. The title was changed from: Diagnosis of Sleep Disorders to: Multiple Sleep Latency Testing and other Sleep Testing Services. MPTAC review. Otolaryngol Head Neck Surg. An AHI between 5 and 15 is considered mild, an AHI between 15 and 30 is moderate, and an AHI greater than 30 is severe. Tubing with integrated heating element for use with positive airway pressure device, 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 mask, replacement only, pair, Full face mask used with positive airway pressure device, each, Face mask interface, replacement for full face mask, each, Cushion for use on nasal mask interface, replacement only, each, Pillow for use on nasal cannula type interface, replacement only, pair, Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap, Headgear used with positive airway pressure device, Chinstrap used with positive airway pressure device, Tubing used with positive airway pressure device, Filter, disposable, used with positive airway pressure device, Filter, non-disposable, used with positive airway pressure device, Oral interface used with positive airway pressure device, each, Exhalation port with or without swivel used with accessories for positive airway pressure devices, replacement only, Water chamber for humidifier, used with positive airway pressure device, replacement, each, **Allowing for a three (3) month supply *Allows for a 10 day delivery before run-out. Chesson AL Jr, Ferber RA, Fry JM, et al. Indications for treatment of obstructive sleep apnea in adults. Not all insurance plans work the same way. ** Medical Management of Obstructive Sleep Apnea Syndrome Typically, your deductible applies to essential CPAP equipment, not including optional accessories. PAP devices have directions from the manufacturing company included for cleaning. Contract language, including definitions and specific inclusions/exclusions, as well as state and federal law, must be considered in determining eligibility for coverage. Collop NA, Tracy SL, Kapur V, et al. AHI greater than or equal to 15 events per hour of sleep in an asymptomatic individual or greater than five (5) events per hour of sleep in a symptomatic individual (e.g., sleepiness, fatigue and inattention). Olejniczak PW, Fisch BJ. There are many different types of sleep-related disorders, including obstructive sleep apnea (OSA), upper airway resistance syndrome (UARS), insomnia, narcolepsy, nocturnal movement disorders, such as Restless Leg Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD), unexplained excessive daytime sleepiness, and arousal disorders (parasomnias). 3 0 obj J Clin Sleep Med. This limits your coverage options, and you may not get the exact product you desire. Contact Carelon online via Carelon's ProviderPortalor call toll-free at 1 (877) 291-0509, 8 a.m. - 5 p.m. PST Monday through Friday to request an order number. 1. 2009; 5(3):263-276. Kryger MH. Sleep education. Daytime electrical stimulation (eXciteOSA) of the tongue is considered experimental/investigation and, therefore, non-covered because the safety and/or effectiveness of this service cannot be established by review of the available published peer-review literature. Anthems insurance plans will cover CPAP supplies that are deemed a medical necessity for OSA (obstructive sleep apnea), such as: However, the cost of other accessories for your CPAP machine, including things like cleaning devices or wipes, batteries, or duplicate machines such as travel versions, will not be covered. As you adjust to CPAP treatment, you may desire additional accessories for more comfortable sleep and easier travel. Hypertension Programs and resources to help you prevent and manage hypertension. Costs for purchasing a machine outright can range anywhere from $250 to $1,000 or more, depending on where you live and the type of machine you need. Technology Evaluation Center (TEC) assessments. Continuous positive airway pressure (CPAP): This is a noninvasive treatment for OSA that involves delivery of pressurized air during sleep through a device that snugly covers the nose. If the criteria are not met, the accessories are considered not medically necessary. Clin Chest Med. Effective October 01, 2021, Internal Medical Policy Committee 11-23-2021, Internal Medical Policy Committee 3-23-2022 Coding update- Silber MH. Rationale section was updated with information about acoustic pharyngometry and SNAP testing.
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