Tests for Obstructive Sleep Apnea to be Covered by
Medicare
OSA is diagnosed by counting the apnea episodes or
breathing disturbances during a specific time span
March 4, 2009 Medicare said yesterday that a new
policy will allow coverage of specified sleep tests used to confirm a
diagnosis of obstructive sleep apnea (OSA), the most common form of
sleep apnea. The Centers for Medicare &
Medicaid Services says this will apply to patients who have clinical signs
and symptoms of OSA.
Sleep
apnea becomes more common as people get older. At least 1 out of 10
senior citizens
over the age of 65 has sleep apnea.
OSA is a condition that is characterized by periods
of apnea during sleep. Apnea is defined as a temporary absence in
breathing. Persons with OSA usually snore; however, not everyone who
snores has OSA.
Persons with OSA also tend to exhibit daytime
drowsiness that can cause accidents with motor vehicles and machinery.
Long term OSA can lead to cardiovascular problems, which is a major
concern for CMS.
A doctor may suspect OSA from taking a patients
medical history and performing a physical examination. The diagnosis
may be confirmed with a sleep test, during which the patients
breathing, heart rate and other factors are recorded and interpreted.
In general, OSA is diagnosed by counting the number
of apnea episodes or breathing disturbances that occur during a specific
time span.
Medicare beneficiaries who have obstructive sleep
apnea face significant risks for cardiovascular disease and other
ailments, said CMS Acting Administrator Charlene Frizzera.
This coverage decision establishes nationally
consistent coverage and assures that beneficiaries who have sleep apnea
can be appropriately diagnosed and referred for treatment.
With this decision, CMS will have nationally
consistent coverage for sleep testing for the diagnosis of OSA. This
includes coverage of more complex tests that are usually furnished in a
sleep laboratory facility as well as many types of home sleep testing.
These tests have previously been covered by local Medicare contractor
policies which in some cases varied from state to state.
This decision does not apply to the use of these
tests for other purposes beyond the diagnosis of OSA. Local Medicare
contractors may continue to determine coverage on other uses within
their own jurisdictions.
The decision memorandum is available on CMS
Coverage Web site
click here.
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.
That means you are unable to get enough air through your mouth and nose
into your lungs. When that happens, the amount of oxygen in your blood
may drop. Normal breaths resume with a snort or choking sound. People
with sleep apnea often snore loudly. 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. If you have it, it is important to get treatment.
It's estimated that more than 12 million American
adults have obstructive sleep apnea. More than half of the people who
have this condition are overweight.
Sleep apnea is more common in men. One out of 25
middle-aged men and 1 out of 50 middle-aged women have sleep apnea.
Sleep apnea becomes more common as you get older.
At least 1 out of 10 people over the age of 65 has sleep apnea. Women
are much more likely to develop sleep apnea after menopause.
African Americans, Hispanics, and Pacific Islanders
are more likely to develop sleep apnea than Caucasians.
If someone in your family has sleep apnea, you're
more likely to develop it.
More
●
Sleep Apnea - (National Heart,
Lung, and Blood Institute) Also available in
Spanish
●
Sleep Apnea - (National
Institute of Neurological Disorders and Stroke) - Short Summary
Keep up with the latest news for senior citizens, baby
boomers
March 4, 2009 Medicare said yesterday that a new
policy will allow coverage of specified sleep tests used to confirm a
diagnosis of obstructive sleep apnea (OSA), the most common form of
sleep apnea. The Centers for Medicare &
Medicaid Services says this will apply to patients who have clinical signs
and symptoms of OSA.