Sleep Apnea Treatment: CPAP Alternatives
The three main warning signs of obstructive sleep apnea are:
Untreated obstructive sleep apnea can lead to long-term serious conditions such as:
Dependence on other enabling machines and devices The 2022 edition of ICD-10-CM Z99. 89 became effective on October 1, 2021. This is the American ICD-10-CM version of Z99.
Obstructive sleep apnea (adult) (pediatric) G47. 33 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM G47. 33 became effective on October 1, 2021.
ICD-10 code Z99. 89 for Dependence on other enabling machines and devices is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
G47. 30 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM G47. 30 became effective on October 1, 2021.
Primary diagnosis code for CPT codes 41512:CodeDescriptionG47.33Obstructive sleep apnea (adult) (pediatric)
CPT/HCPCS Codes Unattended sleep studies: 95800, 95801, 95806 (Facility) and G0398, G0399, and G0400 (Home).
ICD-10 Code for Obstructive sleep apnea (adult) (pediatric)- G47. 33- Codify by AAPC. Diseases of the nervous system. Episodic and paroxysmal disorders. Sleep disorders(G47)
You may report CPAP intolerance as a secondary diagnosis using code Z78. 9 (Other specified health status).
Status code categories V46. 1 (ICD‐9, HCC 82) and Z99. 1 (ICD‐10, HCC 82) are for use when the patient is dependent on respirator (ventilator). This code category also includes weaning from a mechanical ventilator and encounters for respiratory (ventilator) dependence during power failure.
ICD-10 code R06. 81 for Apnea, not elsewhere classified is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .
ICD-10-CM Code for Sleep apnea, unspecified G47. 30.
Disorders characterized by multiple cessations of respirations during sleep that induce partial arousals and interfere with the maintenance of sleep. Sleep apnea syndromes are divided into central (see sleep apnea, central), obstructive (see sleep apnea, obstructive), and mixed central-obstructive types.
Sleep apnea is a common disorder that can be serious. In sleep apnea, your breathing stops or gets very shallow. Each pause in breathing typically lasts 10 to 20 seconds or more. These pauses can occur 20 to 30 times or more an hour. The most common type is obstructive sleep apnea.
nonorganic sleep disorders ( F51.-) A disorder characterized by cessation of breathing for short periods during sleep. A sleep disorder that is marked by pauses in breathing of 10 seconds or more during sleep, and causes unrestful sleep. Symptoms include loud or abnormal snoring, daytime sleepiness, irritability, and depression.
However, not everyone who snores has sleep apnea. When your sleep is interrupted throughout the night, you can be drowsy during the day. People with sleep apnea are at higher risk for car crashes, work-related accidents and other medical problems.
The tenth edition of the International Classification of Diseases (ICD-10) took effect October 1, 2015, replacing ICD-9. As the name says, these codes are used to classify different medical disorders.
Current Procedural Terminology (CPT ) codes are used for health care provider services and medical procedures.
Healthcare Common Procedure Coding System (HCPCS) are used for medical devices such as durable medical equipment, including CPAP, BPAP, CPAP masks, and oxygen therapy. Here are the most common sleep-related HCPCS codes:
Nasal Expiratory Positive Airway Pressure (EPAP)#N#(e.g., the Provent Sleep Apnea Therapy)#N#Aetna considers nasal EPAP (e.g., Provent Sleep Apnea Professional Therapy) experimental and investigational for the treatment of OSA because its effectiveness has not been established.
Aetna considers the AIRvance Tongue Suspension (formerly Repose) System, a minimally invasive technique involving tongue base suspension, and the Encore tongue base suspension, experimental and investigational. These procedures, also referred to as tongue stabilization, tongue stitch or tongue fixation, have been used for treating sleep disordered breathing (SDB) caused by tongue base collapse. No specific criteria exist regarding the diagnosis of tongue base collapse in SDB. Preliminary short-term studies of surgery targeted to alleviate tongue base collapse in SDB have shown subjective improvements in snoring and statistically significant decreases in mean RDI. However, the reported rates of success have been inconsistent among studies, and larger controlled studies with long-term follow-up are necessary to determine whether these lingual suspension procedures safe and effective.
age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist
Aetna considers unattended (home) sleep studies using any of the following diagnostic techniques (see appendix for definition of device types) medically necessary for members with symptoms suggestive of OSA (see appendix) when the home sleep study is used as part of a comprehensive sleep evaluation:
Continued use of a positive airway pressure device beyond the initial authorization period is considered medically necessary if the treating physician documents that the member is benefiting from positive airway pressure therapy. Documentation of clinical benefit is demonstrated by: