Updates to Sleep Apnea Corporate Medical Policy

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The following changes will be effective April 1, 2015, to the Blue Cross and Blue Shield of North Carolina corporate medical policy titled "Sleep Apnea:  Diagnosis and Medical Management". The policy is available on our website, www.bluecrossnc.com, for your reference and will reflect the changes noted below by April 1.

The section of the policy titled “Medical Management of Sleep Apnea” (page 5 of the policy) was changed to provide greater clarity related to the use of oral appliances in the treatment of sleep apnea.  Specifically, there is no longer a requirement to fail a trial of CPAP if the diagnosis is mild to moderate obstructive sleep apnea.  A trial of CPAP continues to be necessary for severe obstructive sleep apnea.

The section of the policy titled “Obstructive Sleep Apnea in Children” (page 9 of the policy) was changed to include “oral appliances may be considered medically necessary for the treatment of clinically significant OSA in children.”