CMS Reimburses Sleep Apnea CPAP Treatment When Diagnosed with Home Testing

Watch-PAT 100 (Itamar Medical, Israel) and ARES (Advanced Brain Monitoring, Inc., Carlsbad, CA) use technology that is not currently recommended by the AASM but that may be useful in certain clinical situations, said Dr. Wardrop.

Whatever system you use, if you become comfortable with it and what the machine is measuring, you’re probably fine, Dr. Wardrop said.

In addition to choosing the appropriate device, the AASM guidelines recommend that home testing should only be performed under the guidance of an AASM-accredited sleep medicine program and in conjunction with a comprehensive sleep evaluation. Testing should be supervised by someone who is board certified in sleep medicine or who fulfills the eligibility criteria for the sleep medicine certification examination.

Finally, physicians need to schedule a follow-up visit to review test results with their patients, the guidelines state.

The Bottom Line

Even though it may take some time to address all the questions and concerns about the CMS ruling and reimbursement and for otolaryngologists to decide whether to offer home testing and what monitoring devices to use, ultimately, the decision is good for our patients and good for resource management, concluded Dr. Davidson.

For the full CMS ruling, go to CMS’s Web site at www.cms.hhs.gov/mcd/viewdecisionmemo.asp?from2=viewdecisionmemo.asp&id=204& .

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