Appendix E - National Coverage Determinations Manual / Sleep Testing for Obstructive Sleep Apnea 240.4.1

Why This Topic Matters

Coverage policy for sleep testing affects whether diagnostic services are payable under Medicare and how sleep medicine workups are documented and interpreted. Understanding the scope of the NCD helps practices align testing choices with Medicare requirements and avoid noncovered services.

Article Sections

1. A. General

   Introduces obstructive sleep apnea and summarizes the major categories of diagnostic sleep testing discussed in the policy. It also provides broad context on attended and unattended testing in sleep-laboratory and portable-monitor settings.

2. B. Nationally Covered Indications

   Describes the overall Medicare coverage framework for sleep testing used in the diagnosis of obstructive sleep apnea. This section addresses the general circumstances under which the named categories of testing are covered.

3. C. Nationally Non-Covered Indications

   Identifies testing situations that are not covered under this national policy. It explains the broad noncoverage category for other diagnostic sleep tests related to obstructive sleep apnea and CPAP-related coverage.

4. D. Other

   Contains a brief closing section with no additional substantive policy content.