692
edits
Changes
→Requirements for Medicare
** A prerequisite trial of noninvasive ventilation without a backup rate, and
** Treatment with continuous positive airway pressure devices.
* '''Central sleep apnea''', i.e., apnea not due to airway obstruction;* '''Hypoventilation'''; and* '''Obstructive sleep apnea (OSA)'''.
See Appendices A&B for further guidance on indications for use and coverage.
Physician/NPP who performs the F2F Encounter
[[File:Respiratory-Assist-Device-Order-Template-Draft-20180412-R10b.pdf|thumb|center]]<br /> [[File:Mr_checklist_rad_e0471.pdf|thumb|center]] Central Sleep Apnea or Complex Sleep ApneaPrior to initiating therapy, a complete facility-based, attended polysomnogram was performed.The polysomnogram documents all of the following.A diagnosis of central sleep apnea (CSA) or complex sleep apnea (CompSA); and there was significant improvement of the sleep – associated hypoventilation with the use of the device on the settings prescribed for initial use at home, while breathing the beneficiary’s prescribed FI02. '''Central sleep apnea (CSA)''' is defined as:# An apnea-hypopnea index (AHI) greater than 5, and# The sum total of central apneas plus central hypopneas is greater than 50% of the total apneas and hypopneas, and# A central apnea-central hypopnea index (CAHI) is greater than or equal to 5 per hour, and# The presence of at least one of the following: Sleepiness, Awakening short of breath, Difficulty initiating or maintaining sleep, frequent awakenings, or nonrestorative sleep, Snoring, Witnessed apneas# There is no evidence of daytime or nocturnal hypoventilation '''Complex sleep apnea (CompSA)''' is a form of central apnea specifically identified by all of the following:# With use of a positive airway pressure device without a backup rate (E0601 or E0470), the polysomnogram (PSG) shows a pattern of apneas and hypopneas that demonstrates the persistence or emergence of central apneas or central hypopneas upon exposure to CPAP (E0601) or a bi-level device without backup rate (E0470) device when titrated to the point where obstructive events have been effectively treated (obstructive AHI less than 5 per hour).# After resolution of the obstructive events, the sum total of central apneas plus central hypopneas is greater than 50% of the total apneas and hypopneas; and# After resolution of the obstructive events, a central apnea-central hypopnea index (CAHI) greater than or equal to 5 per hour.
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