692
edits
Changes
→Justifying ASV
For Complex Sleep Apnea the Medicare requirements for issuing an ASV machine.
* Therapy Optimization should be discontinued and the original settings, from the doctor, restored.
* Titrate to minimize OSA, that is the obstructive AHI to less than 5 per hour. '''''This typically is raising EPAP or pressure until obstructive AHI is less than 5 per hour, we expect this to make the Central and Complex Apnea worse thus failing the current treatment'''''
* Record the central apnea-central hypopnea index (CAHI) (looking for greater than or equal to 5 per hour and greater than 50% of total AHI)
* Document the presence of at least one of the following symptoms: '''''These symptoms are specifically noted by Medicare. These are key symptoms that we look for by asking "How do you feel?". Do not limit your answers to the following and do not fabricate the answers.''''' # Sleepiness, '''''"How do you feel?"'''''# Awakening short of breath, '''''"How do you feel?"'''''# Difficulty initiating or maintaining sleep, '''''"How do you feel?"'''''# Frequent awakenings, or '''''"How do you feel?"'''''# Nonrestorative sleep, '''''"How do you feel?" Nonrestorative sleep is defined as the subjective feeling that sleep has been insufficiently refreshing'''''# Snoring, '''''Can be documented on Sleepyhead'''''# Witnessed apneas '''''Most of us have this one with our significant others'''''
For Central Sleep Apnea
* Therapy Optimization should be discontinued and the original settings, from the doctor, restored.
* Document a ''central apnea-central hypopnea index (CAHI) is greater than or equal to 5 per hour''' also apnea-hypopnea index '''(AHI) greater than 5'''
* Document The sum total of '''central apneas plus central hypopneas is greater than 50% of the total apneas and hypopneas'''
* Document the presence of at least one of the following symptoms: '''''These symptoms are specifically noted by Medicare. These are key symptoms that we look for by asking "How do you feel?". Do not limit your answers to the following and do not fabricate the answers.''''' # Sleepiness, '''''"How do you feel?"'''''# Awakening short of breath, '''''"How do you feel?"'''''# Difficulty initiating or maintaining sleep, '''''"How do you feel?"'''''# Frequent awakenings, or '''''"How do you feel?"'''''# Nonrestorative sleep, '''''"How do you feel?" Nonrestorative sleep is defined as the subjective feeling that sleep has been insufficiently refreshing'''''# Snoring, '''''Can be documented on Sleepyhead'''''# Witnessed apneas '''''Most of us have this one with our significant others'''''
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