blue cross blue shield sleep apnea coverage

Practice Parameters for the Indications for Polysomnography and Related Procedures. CPT Only - American Medical Association, https://jcsm.aasm.org/doi/10.5664/jcsm.7230, https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=330&ncdver=1&DocID=240.4.1&ncd_id=240.4&ncd_version=3&basket=ncd%25253A240%25252E4%25253A3%25253AContinuous+Positive+Airway+Pressure+%252528CPAP%252529+Therapy+For+Obstructive+Sleep+Apnea+%252528OSA%252529&bc=gAAAAAgAAAAA&, http://aasmnet.org/Resources/PracticeParameters/Outofcenter.pdf, http://jcsm.aasm.org/ViewAbstract.aspx?pid=30972, http://pediatrics.aappublications.org/content/130/3/576.full.pdf+html, https://aasm.org/aasm-introduces-new-patient-education-website-sleepeducation-com/, http://jama.ama-assn.org/cgi/reprint/285/22/2936?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=Patient+page%3A++Breathing+problems+during+sleep&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT. Criteria Auto-titrating Positive Airway Pressure (APAP) or Continuous Positive Airway Pressure (CPAP) An APAP device or CPAP device may be considered medically necessary for the treatment of obstructive sleep apnea (OSA) in adults and covered as durable medical equipment when the following criteria are met: APAP Blue Cross Blue Shield of North Dakota is an independent licensee of the Blue Cross Blue Shield Association, serving residents and business in North Dakota. PDF FEP Medical Policy Manual Masks often cost $100 or more, and other equipment ranges between $20 and $100. Sleep. Current medical policy is to be used in determining a Member's contract benefits on the date that services are rendered. More expensive accessories often come with warranties of 1 to 3 years. Practice parameters for using polysomnography to evaluate insomnia: an update. Diagnosis and Medical Management of Obstructive Sleep Apnea Syndrome References were updated. AASM | Payer Policy Scorecards 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. MPTAC review. Want to read more about all our experts in the field? AHRQ Technology Assessment Program. You also avoid the insurance requirements of treatment compliance. Nap study: This term refers to a shorter daytime version of a PSG sleep study. CPAP devices are usually covered by your insurance company on a monthly rental basis, over a period of approximately 3 to 10 months. 1996; 11(2). 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.

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