Currentpremera-bluecrossPolicy 7.01.101

Surgical Treatment of Snoring and Obstructive Sleep Apnea Syndrome

Policy defines medical necessity, investigational, and not-medically-necessary determinations for elective surgical procedures for OSA and snoring (including UPPP, palatopharyngoplasty, hypoglossal nerve stimulation, minimally invasive procedures), site-of-service rules, documentation and coding guidance. This is Part 1 of 2.

Policy Summary

Payerpremera-bluecross

PolicySurgical Treatment of Snoring and Obstructive Sleep Apnea Syndrome

Policy CodePolicy 7.01.101

Change TypeCoding, criteria, and evidence review updates; investigational additions

Effective DateMar 1, 2026

Next Review Date

Key ActionDocument age, AHI, central apneas percentage, CPAP failure or intolerance, BMI, absence of complete concentric collapse on DISE, and name of device to be implanted.

SourceLink

POLICY UPDATE CHANGES

Policy effective date listed as Mar. 1, 2026 with last revised Feb. 10, 2026 and replaces prior policy 7.01.101.

Policy updated with literature review through November 17, 2025; added statement that HNS using other FDA-approved devices (e.g., Genio) is considered investigational for treating clinically significant OSA syndrome.

Interim Review 11/01/23: BMI criterion for HNS in adults changed from ≤32 kg/m² to ≤40 kg/m² to align with expanded FDA indication.

10/01/24: Policy 7.01.101 deleted and replaced with 7.01.554; BMI criteria for HNS updated to ≤35 kg/m² and age thresholds changed (adult ≥18), and pediatric Down syndrome age ranges adjusted to 13-18.

09/01/25: Added policy statement that submucosal cryolysis is considered investigational and added CPT codes 0978T, 0979T, 0980T.

Multiple historical editorial and coding updates (2011-2026) documenting code additions/removals, site-of-service criteria additions, and literature review updates; many edits did not change policy intent.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

MultipleProcedures addressed (examples listed)

2FDA-approved HNS devices referenced

≤32/≤40/≤35BMI thresholds historically

5-14, ≥15AHI thresholds discussed

MultipleCoding updates noted

Coverage summary & scope

This policy defines determinations for medical necessity, investigational, and not medically necessary for elective surgical procedures addressing obstructive sleep apnea (OSA) and snoring, including procedures such as UPPP, palatopharyngoplasty, hypoglossal nerve stimulation (HNS), and minimally invasive techniques. This is Part 1 of 2 and corresponds to policy title "Surgical Treatment of Snoring and Obstructive Sleep Apnea Syndrome" (BCBSA Ref. Policy: 7.01.101), effective Mar. 1, 2026 with last revision Feb. 10, 2026.

High-level clinical thresholds (quick reference)

Adult AHI thresholdAHI/RDI >= 15 events/hour (or AHI/RDI >=5 with associated signs/symptoms)

Pediatric AHI thresholdAHI/RDI >=5 per hour (or AHI/RDI >=1.5 per hour with excessive daytime sleepiness, behavioral problems, or hyperactivity)

HNS (Inspire) adult AHI/central apneasAHI >=15 and <=100 with <=25% central apneas

HNS (Inspire) adult BMIBMI <= 35 kg/m^2 (policy current criterion)

HNS (Down syndrome pediatric/adolescent) AHI/BMIAged 13–18: AHI >10 and <50 with <=25% central apneas; BMI <=95th percentile for age

CPAP/PAP failureResidual AHI >=15 while using PAP

CPAP intoleranceCPAP use <4 hours/night for >=5 nights/week or refusal/inability to use device

Medical‑necessity criteria

Elective surgical procedures reviewed for medical necessity

We will review for medical necessity these elective surgical procedures. The surgical procedure subject to medical necessity review for site of service addressed in this policy is limited to:

Uvulopalatopharyngoplasty (UPPP) is included as a surgical procedure subject to review.

Medically necessary sites of service for certain elective surgical procedures

Certain elective surgical procedures will be covered in the most appropriate, safe, and cost effective site. Preferred medically necessary sites of service include:

Preferred sites of service: Ambulatory Surgical Center (ASC); Off campus-outpatient hospital/medical center; On campus-outpatient hospital/medical center when no ASC within 30 miles or ASC lacks necessary equipment or physician privileges, or ASC guideline prohibits use related to individual's health condition or weight; OR individual is aged 18 or younger; OR service performed with additional service requiring hospital outpatient department in same operative session; OR individual has clinical condition increasing risk for complications.

Investigational / Not covered procedures

Minimally invasive surgical procedures - investigational

The following minimally invasive surgical procedures are investigational for the sole or adjunctive treatment of OSA or UARS:

Investigational minimally invasive procedures: Endoscopically assisted nasomaxillary expansion. Laser-assisted uvulopalatoplasty (LAUP) or radiofrequency volumetric tissue reduction of palatal tissues. Palatal stiffening procedures including CAPSO, implantation of palatal implants (e.g., Pillar), injection of a sclerosing agent. Radiofrequency volumetric tissue reduction of the tongue (Somnoplasty), with or without palatal RF. Submucosal cryolysis therapy (e.g., CryOSAA System). Tongue base suspension (e.g., Airvance System, Repose, Encore). All other minimally invasive surgical procedures not described above.

Submucosal cryolysis specifically added as investigational; CPT codes 0978T-0980T referenced in coding.

The designation of certain procedures as investigational reflects insufficient or limited evidence as summarized in the evidence review; the policy notes that some minimally invasive interventions lack peer-reviewed outcome data and that evidence is insufficient to demonstrate net health benefit. In September 2025 new CPT Category III codes 0978T–0980T were added for submucosal cryolysis and are associated in the policy with investigational status for that therapy.

Coding references

Procedure CPT codes (listed in policy)CPT

0978T	Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil (new code effective 07/01/25)
0979T	Submucosal cryolysis therapy; soft palate only (new code effective 07/01/25)
0980T	Submucosal cryolysis therapy; base of tongue and lingual tonsil only (new code effective 07/01/25)
21199	Osteotomy, mandible, segmental; with genioglossus advancement
21685	Hyoid myotomy and suspension
41512	Tongue base suspension, permanent suture technique
41530	Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session
42145	Palatopharyngoplasty (e.g., uvulopalatopharyngoplasty, uvulopharyngoplasty)
42299	Unlisted procedure, palate, uvula
42950	Pharyngoplasty (plastic or reconstructive operation on pharynx)

CPT - Neurostimulator / HNS codesCPT

64568	Open implantation of cranial nerve neurostimulator electrode array and pulse generator (used to report Genio and Inspire V hypoglossal nerve stimulators)
64582	Open implantation of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array (used to report Inspire IV or earlier Inspire models)
64583	Revision or replacement of hypoglossal nerve neurostimulator array and distal respiratory sensor electrode or electrode array, including connection to existing pulse generator
64584	Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array

HCPCS / supply & procedure codesHCPCS

C1767	Generator, neurostimulator (implantable), nonrechargeable
C1778	Lead, neurostimulator (implantable)
C9727	Insertion of implants into the soft palate; minimum of three implants
S2080	Laser-assisted uvulopalatoplasty (LAUP)

FDA PMA/510(k) & device listings referencedmixed

P130008	Original PMA for Inspire Upper Airway Stimulation system
S039	PMA supplement expanding indications to ages 18-21
S089	PMA supplement expanding indications to pediatric Down syndrome 13-18
S090	PMA supplement updating AHI range to ≥15 and ≤100 and BMI warning to ≤40
S098	PMA supplement (Aug 2024) approval of Inspire V system
K982717	510(k) for radiofrequency ablation (Somnoplasty)
K040417	510(k) for Pillar Palatal Implant
K122391	510(k) for AIRvance (Repose) tongue base suspension
K111179	510(k) for Encore (PRELUDE III) tongue base suspension
P240024	510(k) for Genio System (listed as 2025)

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Codes referenced in revision history / historical code notesmixed

C9727	HCPCS code added Nov 2020
S2080	HCPCS code referenced (removed and re-added historically)
C1767	HCPCS code referenced (added back historically)
C1778	HCPCS code referenced (added back historically)
0978T	CPT category III code added Sept 2025
0979T	CPT category III code added Sept 2025
0980T	CPT category III code added Sept 2025
64568	CPT code description updated Jan 1, 2022
64582	CPT code added Jan 1, 2022
64583	CPT code added Jan 1, 2022

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Provider actions & billing guidance

Prior Authorization

Medical necessity review required

Certain elective surgical procedures addressed in this policy require prior authorization. Providers must submit clinical documentation to support medical necessity before scheduling elective surgery. Required documentation should include the relevant diagnostic testing, prior conservative therapy attempts (e.g., CPAP or oral appliance trials), operative reports when applicable, and device-specific documentation for implanted stimulators.

Elective procedures (eg, UPPP) performed in outpatient or ASC settings are subject to medical necessity review prior to authorization.
Prior authorization must include objective sleep testing (polysomnography or home sleep apnea testing) and documentation of failed or intolerant CPAP when applicable.
For implanted devices, include device name and any manufacturer-specific documentation per plan requirements.

Documentation Required

Background & evidence summary

The policy distinguishes established surgical options with supportive evidence—such as uvulopalatopharyngoplasty (UPPP), maxillomandibular advancement (MMA), and hypoglossal nerve stimulation using the FDA‑approved Inspire device—from a range of minimally invasive or novel procedures that are considered investigational. Examples of investigational approaches include laser-assisted uvulopalatoplasty (LAUP), radiofrequency volumetric tissue reduction, palatal stiffening procedures, tongue base suspension, and submucosal cryolysis, which lack sufficient high-quality evidence to demonstrate a net health benefit.

Evidence area	Summary
LAUP evidence
Systematic reviews and RCTs report frequent complications (eg, globus sensation, dryness, velopharyngeal insufficiency) and limited efficacy (low success/cure rates; some worsening of AHI); evidence insufficient to determine net health benefit.
RF volumetric reduction
Sham-controlled RCTs and cohort studies show single-stage or multistage RF to palate/tongue did not produce consistent, clinically significant AHI or functional improvements; evidence insufficient.
Palatal stiffening
RCTs show mixed results with differing inclusion criteria; some trials report AHI and snoring improvement but overall evidence insufficient to confirm net benefit and define selection criteria.
HNS (Inspire)
Multiple RCTs, meta-analyses, and long-term studies (including STAR trial and 5‑year follow-up) demonstrate improved AHI, ESS, and quality-of-life in selected CPAP‑intolerant patients; benefits maintained up to 5 years in some studies; device has PMA and multiple supplements expanding indications.
Genio device
Nonrandomized multicenter trial (113 patients) showed reductions in AHI and ODI in a subset with secondary outcomes improved; evidence limited and insufficient to define optimal candidates.
NICE 2017
NICE concluded evidence on hypoglossal nerve stimulation was limited in quantity and quality and recommended use only in context of clinical trials.
CMS decision memo
2001 CMS decision memo on CPAP defined AHI/RDI thresholds (treatment warranted for AHI/RDI ≥15; AHI 5–14 requires associated symptoms) and was adapted for surgical management guidance.
FDA PMA/Supplements
Inspire PMA (P130008) and supplements (S039, S089, S090, S098) expanded age, pediatric Down syndrome indication, AHI range, and BMI guidance; Genio has CE mark and 510(k)/PMA/510(k) listings with indicated AHI ranges; submucosal cryolysis not FDA approved.

Definitions & clinical thresholds

Key definitions

DISEDrug-induced sleep endoscopy that replicates sleep with propofol to assess patterns of airway collapse; absence of complete concentric collapse at the soft palate is required for HNS eligibility

PAP failure (definition)Usually defined as residual AHI >=15 to 20 events/hour while using PAP (policy uses residual AHI >=15 as failure for HNS eligibility)

CPAP intolerance (definition)CPAP use less than 4 hours per night for >=5 nights/week, or refusal/inability to use PAP

AHIApnea–Hypopnea Index: average number of apneas or hypopneas per hour of sleep

RDIRespiratory Disturbance Index: number of apneas, hypopneas, or respiratory event-related arousals per hour of sleep/recording time

Medicare / CMS determinations

Effective	Name	Type/Number
2001
CMS decision memorandum for CPAP coverage guidance
NCD
2008
CPAP Therapy for Obstructive Sleep Apnea (OSA)
CAG-00093N (NCD)

Revision history

2011-01-11policy_creation

New policy created (initial notifications and effective dates documented in historical revision log).

2014-07-14replaced

Policy 7.01.554 created replacing prior version; medically necessary criteria refined including AHI thresholds (historical revision noted).

2020-06-01replaced

Policy renumbering and reinstatement activity: 7.01.554 deleted and replaced with 7.01.101; policy statements largely unchanged.

Policy Summary

Payerpremera-bluecross

PolicySurgical Treatment of Snoring and Obstructive Sleep Apnea Syndrome

Policy CodePolicy 7.01.101

Change TypeCoding, criteria, and evidence review updates; investigational additions

Effective DateMar 1, 2026

Next Review Date

Key ActionDocument age, AHI, central apneas percentage, CPAP failure or intolerance, BMI, absence of complete concentric collapse on DISE, and name of device to be implanted.

SourceLink

On This Page

Clinical conditions increasing risk for complications (examples): Anesthesia Risk: ASA classification III or higher; personal history of complication of anesthesia; documentation of alcohol dependence or history of cocaine use; prolonged surgery (> 3 hours). Cardiovascular Risk: uncompensated chronic heart failure (NYHA III or IV); recent MI (< 3 months); poorly controlled, resistant hypertension; recent cerebrovascular accident (< 3 months); increased risk for cardiac ischemia (DES <1 year or angioplasty <90 days); symptomatic cardiac arrhythmia despite medication; significant valvular heart disease. Liver Risk: advanced liver disease (MELD >8). Pulmonary Risk: COPD (FEV1 <50%); poorly controlled asthma (FEV1 <80% despite treatment). Renal Risk: end stage renal disease (on dialysis). Other: morbid obesity (BMI >=50); pregnancy; bleeding disorder (requiring replacement factor, blood products, or special infusion product [DDAVP does not meet this criteria]); anticipated need for transfusion(s).

Examples list from policy

Not medically necessary if criteria not met: If site-of-service criteria listed above are NOT met, the site is considered not medically necessary for certain elective surgical procedures.

Inpatient criteria: Inpatient hospital/medical center is considered not medically necessary for this elective surgical procedure unless specific inpatient criteria are met (examples include renal risk, morbid obesity BMI >=50, pregnancy, bleeding disorder, anticipated transfusion).

Palatopharyngoplasty (including UPPP) - medical necessity

May be considered medically necessary when ALL of the following are met:

Palatopharyngoplasty (including UPPP) - medical necessity: Adult individual with clinically significant obstructive sleep apnea (OSA). Failed an adequate trial of continuous positive airway pressure (CPAP) OR failed an adequate trial of an oral appliance.

Hyoid suspension, surgical modification of the tongue, and maxillofacial surgery (including MMA) - medical necessity

May be considered medically necessary when ALL of the following are met:

Hyoid suspension, surgical modification of the tongue, and maxillofacial surgery - medical necessity: Appropriately selected adult individuals with clinically significant OSA and objective documentation of hypopharyngeal obstruction. Failed an adequate trial of CPAP OR failed an adequate trial of an oral appliance.

Providers must supply objective documentation of hypopharyngeal obstruction.

Adenotonsillectomy - medical necessity

May be considered medically necessary when ALL of the following are met:

Adenotonsillectomy - pediatric medical necessity: Pediatric individuals with clinically significant OSA. Hypertrophic tonsils present.

Adenotonsillectomy is first-line in children with adenotonsillar hypertrophy absent contraindication per pediatric guideline.

Hypoglossal nerve stimulation (Inspire device) - medical necessity (adults)

Hypoglossal nerve stimulation with the FDA approved Inspire device may be considered medically necessary when ALL of the following are met:

HNS (Inspire) - adult eligibility: Individuals aged 18 years and older. AHI >= 15 and <= 100 with <= 25% central apneas. CPAP failure (residual AHI >= 15 or failure to use CPAP >= 4 hrs per night for >= 5 nights/week) or inability to tolerate CPAP. BMI <= 35 kg/m^2. Absence of complete concentric collapse at the soft palate level on drug induced sleep endoscopy (DISE). Name of device to be implanted must be documented.AHI >=15 and <=100; central apneas <=25%; BMI <=35 kg/m^2

Document age, AHI, central apneas, CPAP failure/intolerance, BMI, DISE finding, and device name.

Hypoglossal nerve stimulation - medical necessity (Down syndrome pediatric/adolescent subgroup)

May be considered medically necessary when ALL of the following are met:

HNS - Down syndrome pediatric/adolescent subgroup: Individuals aged 13 to 18 years. AHI > 10 and < 50 with <= 25% central apneas after prior adenotonsillectomy. Have either a tracheotomy OR ineffectively treated with CPAP due to noncompliance, discomfort, undesirable side effects, persistent symptoms despite compliant use, or refusal to use the device. BMI <= 95th percentile for age. Absence of complete concentric collapse at the soft palate level on DISE.AHI >10 and <50; central apneas <=25%; BMI <=95th percentile for age

If individual has Down syndrome, document prior adenotonsillectomy plus standard HNS documentation (age, AHI, central apneas, CPAP failure/intolerance, BMI, DISE, device name).

Not medically necessary

The policy states the following are not medically necessary:

General not medically necessary statements: Surgical treatment of OSA that does not meet the above criteria. Implantable hypoglossal nerve stimulators for all other indications not specified are considered investigational / not medically necessary. All interventions for treatment of snoring in the absence of documented OSA are considered not medically necessary (snoring alone is not a medical condition), including LAUP, palatal stiffening procedures, and radiofrequency volumetric tissue reduction of the palate.

Device-specific not medically necessary statement: Hypoglossal nerve stimulation with other FDA approved devices (e.g., Genio) are considered investigational for the treatment of clinically significant OSA syndrome.

This policy added statement that non-Inspire HNS devices (e.g., Genio) are investigational for OSA.

Hypoglossal nerve stimulation documentation

For hypoglossal nerve stimulation (HNS) requests, provide comprehensive device and patient eligibility documentation. Include all of the following elements in the submission to support medical necessity:

Patient age and date of birth (note device-specific age limits; e.g., Inspire approved ≥18 years for adults; pediatric Down syndrome criteria when applicable).
Objective OSA severity: AHI (apnea–hypopnea index) or RDI from a recent sleep study, with date and testing modality noted.
Percent central apneas (must be ≤25% for covered indications).
Documentation of CPAP trial and failure or intolerance: residual AHI ≥15 on CPAP OR documented inability/unwillingness to use CPAP ≥4 hrs/night on ≥5 nights/week, with duration and adherence data.
Body mass index (BMI) with date (policy notes BMI thresholds historically variable; e.g., covered Inspire BMI ≤35 kg/m² in adults).
Drug-induced sleep endoscopy (DISE) findings confirming absence of complete concentric collapse at the soft palate level (report and interpretation).
Name of the device to be implanted (eg, Inspire; Genio considered investigational per policy).

Documentation Required

Document OSA severity and PAP trial/failure

Document OSA severity and prior PAP therapy carefully. Sleep study metrics and clear CPAP usage/adherence evidence are required to determine medical necessity for surgical or device-based interventions.

Provide AHI or RDI value with test date and type (in-lab polysomnography or validated home sleep apnea test).
Define PAP usage/adherence: average nightly use in hours and nights per week; device downloads or adherence reports are preferred.
When claiming CPAP failure, include either residual AHI ≥15 while on CPAP or documented inability to use CPAP ≥4 hours/night on ≥5 nights/week despite attempts at optimization.

Documentation Required

BMI and age documentation for HNS

Historically, BMI thresholds and age limits for HNS have varied by device and indication. Document the patient's BMI at the time of evaluation and note any device-specific age restrictions. For pediatric Down syndrome indications, document age and relevant growth-percentile criteria.

Record BMI with date; note that Inspire coverage specifies BMI ≤35 kg/m² for adults and different percentiles apply for pediatric Down syndrome cases.
Include age verification and any device-specific labeling that affects eligibility.

Billing Rule

Use of CPT 64568 for HNS devices

Use CPT 64568 to report implantation of hypoglossal nerve stimulation systems where appropriate per current coding guidance. Include the applicable implantation and system codes with the claim and supporting operative reports.

CPT 64568 may be used for implantation of cranial nerve neurostimulator electrode arrays and pulse generators where applicable (see coding section).
Check device-specific guidance for additional CPT or HCPCS codes required for generator, lead, or ancillary components.

Billing Rule

Code alignment and historical code changes

Billing professionals must submit claims using the codes valid for the date of service. Note that HCPCS code C1607 has been removed from this policy effective March 1, 2026 and reclassified under non-covered policy 10.01.533; follow current code sets at time of service.

Use the current CPT/HCPCS codes in effect on the date of service when reporting HNS implantation and related services.
C1607 was removed from this policy effective 2026-03-01 and moved to non-covered policy 10.01.533 — do not use C1607 for claims under this policy after that date.

Prior Authorization

Prior authorization implied for device procedures

Many implantable device procedures are subject to prior authorization per the member's plan. Verify plan-specific prior authorization requirements and obtain approval before implantation when required.

Prior authorization requests should include all documentation listed in other callouts (sleep testing, CPAP trial/adherence, DISE, BMI, device name, and operative plan).
Failure to obtain prior authorization when required may result in claim denial or member financial liability.

Documentation Required

Objective documentation for hypopharyngeal obstruction

When considering surgeries targeting the hypopharynx (eg, hyoid suspension, tongue-base procedures, MMA), include objective documentation demonstrating hypopharyngeal obstruction. This documentation supports selection of these procedures and is required for medical necessity review.

Objective evidence of hypopharyngeal obstruction may include imaging, endoscopic evaluation (including DISE), manometry, or other specialty-specific objective assessments with clear interpretation indicating obstruction at the hypopharyngeal level.
Correlate objective findings with clinical symptoms and prior treatment attempts (eg, failed CPAP or oral appliance).
For procedures that address multilevel obstruction, specify the level(s) treated and provide objective evidence for each level.

Named clinical thresholds (summary)

AHI ranges (adult severity)Mild 5–14; Moderate 15–29 (policy references 15–30); Severe >=30

AHI thresholds used for coverageAHI/RDI >=15 (or 5–14 with associated symptoms) — HNS adult eligibility requires AHI >=15 and <=100

BMI thresholds (history/current)Historically varied: <=32 kg/m^2 → <=40 kg/m^2 (FDA supplement) → policy aligned to <=35 kg/m^2 in some edits; current policy uses BMI <=35 for Inspire HNS adults

Age requirements (HNS/Inspire)Original Inspire PMA adults >=22; supplements expanded to include ages 18–21 and pediatric Down syndrome 13–18; policy generally requires adults >=18 for some updates

CPAP failure (coverage detail)Residual AHI >=15 while using PAP (PAP usage often defined as >=5 nights/week with >4 hrs/night)

2020-11-01coding_update

HCPCS code C9727 added to coding section.

2022-01-01coding_update

CPT codes 64582, 64583, and 64684 added; description for CPT 64568 updated.

2023-11-01interim_review_material_change

Interim review updated BMI criterion for HNS in adults from ≤32 kg/m² to ≤40 kg/m² to align with expanded FDA indication (approved 06/08/2023).

2024-10-01revised_material_change

Policy 7.01.101 deleted and replaced with 7.01.554; BMI criteria for HNS updated to ≤35 kg/m², adult age threshold changed to ≥18 years, and Down syndrome pediatric age ranges adjusted to 13–18; HCPCS codes C1767 and C1778 added back.

2025-09-01added_material_change

Added investigational statement that submucosal cryolysis is considered investigational and added CPT codes 0978T, 0979T, and 0980T.

2026-01-01coding_update

HCPCS code C1607 was added effective January 1, 2026 (later removed from this policy).

2026-03-01annual_reviewLatest

Policy effective date Mar. 1, 2026; last reviewed Feb. 10, 2026. Policy updated with literature review through Nov. 17, 2025 and added statement that HNS using other FDA‑approved devices (e.g., Genio) is considered investigational for treating clinically significant OSA; HCPCS code C1607 removed from this policy and moved to non‑covered policy 10.01.533.