According to an American Academy of Sleep Medicine (AASM) special update, the academy has “suspended indefinitely the requirement for accredited sleep centers to score hypopneas according to the 3 percent oxygen desaturation criterion in the new AASM scoring manual.”
The AASM Standards for Accreditation of Sleep Disorders Centers require that each epoch of each polysomnogram must be scored for sleep staging, arousals, respiratory events and limb movement in accordance with The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology, and Technical Specifications.
Version 2.0 of the scoring manual was published late last year and features a number of new rules, including the criterion that there is a more than or equal to 3% oxygen desaturation from pre-event baseline or the event is associated with an arousal.
Despite the rule, the coverage policies of some insurance payers, including Medicare, continue to require an oxygen desaturation of more than or equal to 4% when scoring hypopneas.
“Payers can deny payment or deny patients their therapeutic equipment if documentation doesn’t comply with their requirements for diagnostic testing,” according to the AASM. “Therefore, it is critical for sleep centers and durable medical equipment suppliers to document compliance with payer requirements.”
According to the AASM, it is acceptable for accredited sleep centers to score hypopneas using a criterion of 4%. However, accredited sleep centers must document in the patient’s record whether hypopneas were scored using an oxygen desaturation criterion of 3 % or 4%.
