Mysliwiec V, Martin JL, Ulmer CS, et al. The relationship between esophageal pressure and apnea hypopnea index in obstructive sleep apnea-hypopnea syndrome. Device expenses incurred during the first three (3) months of rental will be applied to the purchase price. 2007; 3(7):737-747. Many Blue Cross PPO type plans have excellent out-of-network coverage, and many of our patients end up paying the same or even less with us than with an in-network provider. Medical Policy | Blue Cross and Blue Shield of Illinois This change was approved at the November 29, 2007 MPTAC meeting. 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. CPAP machine prices start around $250 and can reach $1000 or higher. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. American Academy of Sleep Medicine (AASM). risk of central sleep apnea, (chronic use defined as use of opioids on most days per week for greater than 3 months) Obesity hypoventilation syndrome, defined as pCO 2 greater than 45 mm Hg and pO 2 less than 60 mm Hg on arterial blood gas. Click the button below to request a free, no-obligation verification. 2009; 5(3):263-276. 1999; 131(7):485-491. American Sleep Disorders Association and Sleep Research Society. These coverage types are separate from one another. It isnot intended to be a recommendation of one product over another, and is not intended to represent a complete listing of all products available. Device expenses incurred during the first three (3) months of rental will be applied to the purchase price. 1 0 obj Coveredsleep apneaDiagnosis Codes for Procedure Code E0601, Non-Covered Diagnosis Codes for Procedure Code E0471. Sleep. MPTAC review. This condition is also defined as a score greater than or equal to 10 on the Epworth Sleepiness Scale. Obstructive sleep apnea. 3 0 obj Sleep apnea is classified as mild, moderate, or severe, depending on the AHI reading. Again, this will depend on your individual insurance plan and provider, but in the case of Anthem they offer the following replacement schedule: Generally speaking, most insurance companies will authorize the replacement of CPAP masks, tubing, and filters every 90 days. Arch Dis Child. If you fail to meet these requirements, you have to begin the process again. 4 0 obj Likewise, medical policy, which addresses the issue(s) in any specific case, should be considered before utilizing medical opinion in adjudication. This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. While the use of actigraphy has been demonstrated to be useful in the detection of sleep problems in healthy or normal individuals, potential benefits for individuals with suspected sleep disorders have not been shown. 2002; 347(7):498-504. 2 0 obj Premera Blue Cross, the largest health plan in the Pacific Northwest covering over 2.1 million members in Washington and Alaska. 2004; 51(1):169-186. % Updated the formatting of the Position Statement section. Dise Is A Prerequisite To Inspire 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.
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