Obstructive and Central Sleep Apnea Treatment (for Nebraska Only)
Summarizes evidence and coverage-relevant findings for a range of non-CPAP devices used to treat obstructive and central sleep apnea, including positional therapy devices, nasal dilators, intranasal expiratory resistance valves (EPAP), oral appliances, and investigational devices; intended for clinicians and reviewers applying UnitedHealthcare Nebraska policy.
Added instruction to refer to the Medical Policy titled Sleep Studies (for Nebraska Only).
Added notation that polysomnography should be repeated if there has been clinically significant weight loss or gain, changes in cardiovascular disease, or persistent/recurrent symptoms since the last study.
Replaced criterion requiring 'diagnosis of moderate to severe OSA (AHI or RDI ≥ 15)' with 'moderate to severe OSA (AHI ≥ 15 or RDI ≥ 15) as determined by Polysomnography (Attended)'.
Replaced wording for implantable hypoglossal nerve stimulation in adolescents with Down syndrome to specify diagnosis of severe OSA as determined by Polysomnography (Attended) with AHI ≥ 10 and RDI ≤ 50 events per hour.
Added definition of 'Respiratory Disturbance Index (RDI)'.
Added CPT/HCPCS codes 0964T, 0965T, 0966T, and E0490 to applicable codes.
Updated FDA and References sections to reflect the most current information.
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