tci Medicare Compliance & Reimbursement - 2008 Issue 13

Industry Notes: CMS Opens Door To CPAP Payment

Plus: Look for revised RARCs and CARCs If you were worried about narrow diagnosis issues surrounding continuous positive airway pressure (CPAP) billing, worry no more. Medicare has expanded its CPAP policy to now allow coverage for beneficiaries with obstructive sleep apnea (OSA) who have been diagnosed using a home sleep test. In its March 13 coverage announcement, CMS noted that some OSA patients fail to improve while on treatment, so CMS will therefore limit initial CPAP coverage for OSA to 12 weeks. Those patients who respond well to the therapy will be eligible for further coverage. "Our revised policy...

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