blue cross blue shield sleep apnea coverage

A liner used in conjunction with a PAP mask is considered a comfort and convenience item and is considered a non-covered item or service. If youre considering starting CPAP therapy, you may be wondering whether you can offset part of this cost with your insurance plan. Obtain an order number Login or register with Carelon's ProviderPortal Phone 1 (877) 291-0509 However, how often they replace these, and how much of the cost your insurance covers, of course depends on your policy and the company youre with. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 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. 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. Validation of actigraphy for determining sleep and wake in children with sleep disordered breathing. However, youre probably wondering about insurance. BiPAP without back-up rate may be considered medically necessary for the treatment of OSA in adults and may be considered as durable medical equipment when the following criteria are met: BiPAP without back-up rate devices not meeting the criteria as indicated in this policy are considered not medically necessary. The policy is available on our website, www.bluecrossnc.com, for your reference and will reflect the changes noted below by April 1. Marino M, Li Y, Rueschman MN, et al. Paying for your equipment directly gives you the opportunity to compare products and choose the CPAP equipment you find most suitable. 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. 2007; 137(5-6):97-102. Schechter MS. American Academy of Pediatrics technical report: diagnosis and management of childhood obstructive sleep apnea syndrome. endobj Device expenses incurred during the first three (3) months of rental will be applied to the purchase price. Continued use beyond the first three (3) months of therapy. Mulgrew AT, Fox N, Ayas NT, Ryan CF. Documented compliance with objective findings (i.e., compliance chip, telemonitoring, computer software) of device usage for three (3) consecutive months; The individual is experiencing success in treatment. Best Anti-Snoring Mouthpieces & Mouthguards, CPAP: Continuous Positive Airway Pressure, Link Between Sleep Apnea and Heart Disease, Medical and Brain Conditions That Cause Excessive Sleepiness, Drowsiness or falling asleep while driving, You have an hourly AHI between 5 and 14 and a, AHI index between 5 and 14, along with a comorbidity related to obstructive sleep apnea; or. Removed ICD-9 codes from Coding section. AHRQ Technology Assessment Program. Information on this website should not be construed as medical advice. 2004; 8(3):611-630. The document header wording was updated from Current Effective Date to Publish Date. References were updated. As you adjust to CPAP treatment, you may desire additional accessories for more comfortable sleep and easier travel. Excessive daytime sleepiness: This refers to a condition where a person feels very drowsy during the day, even after getting adequate nighttime rest, and has a tendency to fall asleep or requires extra effort to avoid sleeping in inappropriate situations, such as at work or driving. The exclusion of obstructive sleep apnea (OSA) as the predominant cause of sleep-associated hypoventilation; For BPAP-ST, the ruling out of CPAP as effective therapy if OSA is a component of the sleep-associated hypoventilation; Significant improvement of the sleep-associated hypoventilation with the use of either PAP device on the settings that will be prescribed for initial use at home, while breathing the individual's prescribed FIO2. Many portable tests have been proposed as alternatives to laboratory-based PSG for the diagnosis and follow-up of sleep disorders. Chest. % These tests include, but are not limited, to: nap studies, actigraphy, diagnostic audio-taping, topographic brain mapping, and acoustic pharyngometry. The machine attaches to a mask that you wear over your nose, mouth, or both, and delivers pressurized air throughout the night to keep your airway open. Home/Portable sleep study (may also be known as NightWatch System, AutoSet Recorder, Morpheus System): A diagnostic test proposed for home use which may be self-administered or attended by a technician. Liners must not be billed as replacement interface for a PAP mask or as a replacement cushion for use on nasal mask interface. The criterion standard diagnostic test for sleep disorders is a polysomnogram performed in a sleep laboratory.2 A standard polysomnogram includes EEG, submental electromyogram (EMG) and electrooculogram (to detect rapid eye movement [REM] sleep) for sleep staging. Neurol Clin. JAMA. Sleep. Blue Cross Blue Shield of Massachusetts has delegated utilization management to Carelon Medical Benefits Management for Sleep Disorder Management. Products or services advertised on this page may be offered by an entity that is affiliated with us. minimally invasive solutions for patients with obstructive sleep apnea, announced today that three new Blue Cross Blue Shield Association ("BCBSA") healthcare plans have issued positive coverage policies of Inspire therapy. 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. An American Sleep Disorders Association Report. Your doctor must determine which type of study is right for you. Controversies in sleep medicine: terminology and definitions in sleep-disordered breathing. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications. 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. 2013; 36(11):1747-1755. 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. Practice parameters for the use of actigraphy in the assessment of sleep and sleep disorders: an update for 2007. Note:See the table below for the usual maximum amount of accessories considered to be medically necessary. Practice Parameters for the Indications for Polysomnography and Related Procedures. Description and validation of the apnea risk evaluation system: a novel method to diagnose sleep apnea-hypopnea in the home. Assessing efficacy, outcomes and cost savings for patients with obstructive sleep apnea using two diagnostic and treatment strategies. An AHI/RDI greater than 30 is consistent with severe OSA. Five more Blue Cross Blue Shield health plans have extended coverage to Inspire Medical Systems' (NYSE: INSP) sleep apnea therapy, the company said today. Sleep. 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. Easy Breathe works with your Blue Cross PPO plan as an out-of-network provider. Document was revised to remove statements about MSLT and MWT which are now addressed in separate CG-MED-43. Most machines record your use for you. Additionally, nap sleep is not physiologically the same as nighttime sleep and does not adequately reflect the range of sleep phases required for proper diagnosis, therefore, results are not accurate when compared to the current standard of a full polysomnography (PSG). ; Swiss Respiratory Polygraphy Registry. References and Coding sections were also updated. m|(=IPYAcmAa#nhwRz(v^6;Ut4?o+UIv(($HSnG>:~;khOFtUG+'@Gq^B0kT$Ae/a#*lJk=aZdj~\:POhI-y p;6p=E?t:M?h=U,>) ]1r!!pr8lDbDadJJV|p6l-Dq. 2000; 3(4):169-172. Sleep. MPTAC review. 2 0 obj Fletcher EC, Stich J, Yang KL. - Any additional medical records, such as your sleep study, that your insurance company requests. 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. The current body of evidence supporting the use of actigraphy for individuals with sleep disorders is insufficient to allow adequate conclusions regarding efficacy. 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. 3 months/90 days. 3 months/90 days. ** Medical Management of Obstructive Sleep Apnea Syndrome Most insurance plans offer partial coverage for CPAP machines once you meet your deductible. The necessary doctors appointments and sleep studies come with their own costs, depending on your insurance plan and associated deductible. Insurance providers almost always request that you present an obstructive sleep apnea diagnosis before starting coverage for a CPAP machine and related equipment. The occlusion is usually in the back of the tongue and/or flabby tissue in the upper airway. References were updated. 3 results found for search term : sleep apnea Hypertension Programs and resources to help you prevent and manage hypertension. It happens when the muscles in the throat relax and block the air passages to make sure . 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 or CPAP devices not meeting the criteria as indicated in this policy are considered not medically necessary. American Academy of Sleep Medicine (AASM). 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. Thankfully, the majority of Anthem Blue Cross Blue Shield PPO and HMO plans cover CPAP therapy supplies. <> 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. 1997; 20(6):423-487. Replacement of PAP Devices Blue Care Network's medical policy on the diagnosis and management of obstructive sleep apnea includes coverage for home sleep studies for members with symptoms of OSA without other comorbid conditions. 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. If you're ready for more, sign up to receive our email newsletter! Kapur VK, Auckley DH, Chowdhuri S, et al. The following codes for treatments and procedures applicable to this document are included below for informational purposes. More advanced machines tend to cost more. For the purposes of this document, the terms AHI and RDI are interchangeable, although they may differ slightly in clinical use. 2003, 24(2):307-313. 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. MPTAC review. 3 0 obj Inclusion or exclusion of a procedure, diagnosis or device code(s) does not constitute or imply member coverage or provider reimbursement policy. Does Blue Cross Blue Shield Federal Cover Sleep Apnea Oral Appliance. Your AHI is the average number of partial or complete breathing cessation events you experience per hour. Some rental plans may include the cost of replacement equipment, which is something to bear in mind when comparing the cost of buying outright versus going with insurance. Actigraphy: This is a method used to study sleep-wake patterns and circadian rhythms by assessing the subjects movement over a period of time. References were updated. MPTAC review. You must also adhere to the same compliance requirements as Medicare recipients, namely using the machine at least 4 hours every night on 70% of nights. 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. Directory Validation Instructions (No Surprises Act), Recredentialing & Credentialing Applications. Your provider will bill your insurance company monthly, and, at the end of this rental period, you will own the device. Benefits Application This medical policy relates only to the services or supplies described herein. 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. Continued use beyond the first three (3) months of therapy Additional appliances should be denied as not medically necessary. Sleep. The updated 2009 AASM document does not address MWT, nap studies, audio recording, SNAP testing, acoustic pharyngometry or topographic brain mapping (Epstein, 2009). Either a heated humidifier or a non-heated humidifier is eligible for use with a covered PAP device when prescribed by the treating physician to meet the needs of the individual. 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. The Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea: Synopsis of the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines. actigraphy, including use of static charge sensitive beds; diagnostic audio recording, with or without pulse oximetry to document sleep apnea; Diagnostic audio recording, with or without pulse oximetry, to document sleep apnea; Actigraphy or static charge sensitive beds. BlueCHiP for Medicare and Commercial Intraoral appliances for use in the treatment of documented mild to moderate obstructive sleep apnea are covered under the member's durable medical equipment service. The title was changed from: Diagnosis of Sleep Disorders to: Multiple Sleep Latency Testing and other Sleep Testing Services. 2007; 3(7):737-747. Effective October 01, 2021, Internal Medical Policy Committee 11-23-2021, Internal Medical Policy Committee 3-23-2022 Coding update- 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. An evidence review cosponsored by the American Academy of Sleep Medicine, the American College of Chest Physicians, and the American Thoracic Society. Your coverage which services your plan helps pay for and how the payment structure works depends on the terms of your specific plan. We work with Anthem Blue Cross and Blue Shield PPO plans nationwide. 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. Starting January 1, 2018, AIM Specialty Health (AIM) will conduct clinical reviews for all sleep studies on behalf of Premera. Agency for Healthcare Research and Quality (AHRQ), Rockville, MD; August 8, 2007. Save my name, email, and website in this browser for the next time I comment. Dise Is A Prerequisite To Inspire Effective April 01, 2023. Standards of Practice Committee of the American Academy of Sleep Medicine (AASM). Available at: Berry RB, Quan SF, Abreu AR, et al. Portable sleep studies for the diagnosis of obstructive sleep apnea syndrome. 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. That said, coverage varies depending on your plan, insurance company, and authorization requirements. 1997; 20(6):406-422. Home sleep studies are covered to diagnose obstructive sleep apnea for members who fit the following description: 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. American Academy of Sleep Medicine (AASM). Validity of actigraphy compared to polysomnography for sleep assessment in children with autism spectrum disorder. A replacement device is not covered if due to misuse or abuse and is considered a non-covered service. 1 0 obj Your email address will not be published. 2013; 9(2):125-131. Before making a final decision, please read the Plan's federal brochure (RI 71-005). Acoustic Reflection Pharyngometry (Eccovision): This is a noninvasive device that uses acoustic signal processing technology to provide a graphical representation of airway patency. Sleep disorder studies are used to determine or confirm a diagnosis related to sleep disturbances. Respiratory polygraphy in sleep apnea diagnosis. CPAP sanitizer cleaning systems are considered convenience items and therefore non-covered. Am J Respir Crit Care Med. endobj 2 0 obj After reading and interpreting the results of your sleep study, your doctor may diagnose you with sleep apnea and work with you to develop a treatment plan. Filters, which need to be replaced frequently, run between $5 and $30 each. Flemons WW. The appropriate setting for standard CPAP treatment is determined during a titration sleep study. Horizon Blue Cross Blue Shield of New Jersey partnered with the March of Dimes to offer an eLearning session on implicit bias called Awareness to Action: Dismantling Bias in Maternal and Infant Healthcare. Monahan KJ, Larkin EK, Rosen CL, et al. Available at: Epstein LJ, Kristo D, Strollo PJ, et al. 2011; 7(5):531-548. Sleep. Sleep apnea is a harmful condition that can have substantial negative impacts on health. 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. 1997; 20(12):1208. Available at: Journal of the American Medical Association. 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. Shift work sleep disorder (SWSD): A sleep disorder that is related to unusual or constantly changing work schedules and results in symptoms of insomnia or excessive sleepiness. Otolaryngol Head Neck Surg. Medical policy list. A clarification was made within the Definitions section regarding severe OSA as being defined as an RDI/AHI of greater than 30 (not 40). Click the button below to submit your insurance information to us and get started! Can actigraphy measure sleep fragmentation in children? Kushida CA, Efron B, Guilleminault C. A predictive morphometric model for the obstructive sleep apnea syndrome. Clinical practice. Patient Page. C. Recent Home Sleep Apnea Test (HSAT) (less than 1 year old) confirmed to be non-diagnostic: 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. The relationship between esophageal pressure and apnea hypopnea index in obstructive sleep apnea-hypopnea syndrome. If the criteria are not met, the accessories are considered not medically necessary. These are not considered 'interfaces' as defined in this policy. 1. Fargo, N.D., 58121. Diagnosis and management of childhood obstructive sleep apnea syndrome. If your insurance company determines you are not using the machine frequently enough as per your policy, they may stop covering their portion of the machine rental. 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. The American Academy of Sleep Medicine (AASM) Clinical Guideline for the Evaluation, Management and Long-term Care of Obstructive Sleep Apnea in Adults, updated in 2009, stated: Actigraphy alone is not indicated for the routine diagnosis of obstructive sleep apnea (OSA) but may be a useful adjunct to portable monitors (PMs) when determining the rest-activity pattern during the testing period (Option) (Epstein, 2009). 2017; 13(10):1199-1203. Oral cushion for combination oral/nasal mask, replacement only, each. Only 10% allow for more frequent replacement. American Academy of Sleep Medicine. The medically necessary indications for home portable sleep testing were reordered placing the last criterion for OSA as the first criterion. MPTAC review. J Clin Sleep Med. Apnea-Hypopnea index (AHI) or Respiratory disturbance index (RDI): A measure of apnea severity defined by the total number of episodes of apnea or hypopnea during a full period of sleep divided by the number of hours asleep. Front Psychiatry. J Clin Sleep Med. Government Agency, Medical Society, and Other Authoritative Publications: ActigraphyApnea/Hypopnea Index (AHI)Apnea Risk Evaluation System (ARES)Nap StudyObstructive Sleep Apnea (OSA)Pharyngometry AcousticQuantitative EEG MappingSleepStripSNAP Testing SystemStatic Charge Sensitive BedsTopographic EEG Mapping. Updated the formatting of the Position Statement section. Apnea: A transient period where breathing ceases. See the table below for the usual maximum amount of accessories considered to be medically necessary. Regardless of utilization, a supplier must not dispense more than a three (3) month quantity at a time. Pediatrics. MPTAC review. 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: The potential benefits of diagnostic audio recording, used alone or in conjunction with pulse oximetry, have not been demonstrated to provide clinical benefits equivalent to PSG. Updated Coding section with 01/01/2009 CPT changes; removed 0089T deleted 12/31/2008. Your email address will not be published. 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). endobj Another benefit to paying a medical equipment supplier directly is the wider choice of products available to you. 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. Behavioral Health Companion Benefit Alternatives (CBA) manages behavioral health benefits for the State Health Plan. The Eccovision Acoustic Reflection Pharyngometer (Hood Laboratories; Pembroke, MA) is a noninvasive testing device intended to measure the upper respiratory airway by means of acoustic reflection. Providers have the opportunity to review . Hyde M, O'Driscoll DM, Binette S, et al. If youre diagnosed with sleep apnea and require CPAP therapy, its likely your insurance will cover the cost of the device, and the replacements required thereafter. Available at. Smith MM, McCrae CC, Cheung JJ, et al. compliance chip, telemonitoring, computer software), confirming that the member has been adhering to PAP therapy and is benefiting from its use. Most CPAP machines cost between $500 and $800. This condition is also defined as a score greater than or equal to 10 on the Epworth Sleepiness Scale. Topographic brain mapping has been briefly described in the evaluation and diagnosis of OSA. Sleep education. Flemons WW, Littner MR, Rowley JA, et al. There is no additional payment for liners used with a PAP mask. Coveredsleep apneaDiagnosis Codes for Procedure Code E0601, Non-Covered Diagnosis Codes for Procedure Code E0471. CPAP therapy is effective, but it can also be expensive. Home diagnosis of obstructive sleep apnea-hypopnea syndrome. Sleep. Agreement rates between actigraphy, diary, and questionnaire for children's sleep patterns. Rationale section was updated with information about acoustic pharyngometry and SNAP testing. 2017; 13(3):479504. While such methods do potentially identify occurrences of sleep apnea, other aspects of physiological functioning are not recorded simultaneously, thus providing an incomplete clinical picture and allowing the possibility of misdiagnosis. When you choose to buy your CPAP equipment without insurance, you can skip the rent-to-own process and own your machine right away. O'Driscoll DM, Foster AM, Davey MJ, et al. It can be mild, moderate, or severe, based on the number of times each hour that breathing stops (apnea) or slows (hypopnea). D'Andrea LA. If your prescription specifies a certain amount of refills, you can receive your CPAP items the number of times listed. Among state Medicaid programs, 51% adhere to these guidelines, but 39% allow for less frequent replacement of CPAP equipment. Coding section was updated. Contract language, including definitions and specific inclusions/exclusions, as well as state and federal law, must be considered in determining eligibility for coverage. Therefore, it is particularly important that individuals with severe OSA should have an initial trial of CPAP and that all reasonable attempts are made to continue treatment with CPAP, prior to the decision to switch to an oral appliance. More than 75 percent of the apneas or hypopneas must have an obstructive pattern. Damon Wiseley is a Registered Respiratory Therapist and Certified Pulmonary Function Technologist. Diagnosis of Sleep Disorders and Treatment of Obstructive Sleep Apnea, Polysomnography and Other Sleep Studies in Adults, Polysomnography and Other Sleep Studies in Children. More expensive accessories often come with warranties of 1 to 3 years. Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. JAMA. Chesson AL Jr, Ferber RA, Fry JM, et al. If the CPAP therapy helps improve your sleep apnea symptoms during the 12-week period, Medicare continues to cover the cost of your CPAP equipment. Added reference for Centers for Medicare and Medicaid Services (CMS) National Coverage Determination (NCD).

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