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Medical Policy Update for January 24, 2023

Medical GuidelinesReason for Update
Sleep Apnea: Diagnosis and Medical Management (PDF)

Specialty Matched Consultant Advisory Panel review 8/17/2022.  The following was added to item II B in the When Diagnosis and Medical Management of Sleep Apnea is covered section: “One or more of the following:

  • Individual is not a candidate for CPAP therapy
  • CPAP therapy has not been effective despite a 45-day trial and participation in a CPAP compliance program
  • Individual has tried CPAP but has not been compliant despite a 45-day trial and participation in a CPAP compliance program
  • Individual prefers to use an oral appliance rather than CPAP as the initial therapy”