Effective Jan. 1, 2006 the oxygen desaturation requirement has been eliminated from the documenting criteria for central sleep apnea or complex sleep apnea within the Medicare Coverage for a Respiratory Assist Device (RAD).
According to Hillary Theakston, director of communications at ResMed Corp., the change is a break in the clouds for the industry. After repeated cuts in oxygen and mobility, the updated RAD Guidelines are some of the only good news in reimbursement in months. The previous RAD guidelines included documenting diagnosis of oxygen saturation — 88 percent for at least five consecutive minutes while breathing the patient’s usual Fi02.
The new reimbursement changes support a patient-driven solution. With the elimination of the oxygen desaturation component, patients receive the appropriate treatment the first time, based predominantly on the diagnosis of central sleep apnea. The changes were affected through a partnership between the industry and physicians because they recognized a need to improve patient care. Under the previous protocol, patients were being put on ineffective systems, which were costing more money in the long run. The updated guidelines are likely to save money, increase efficiency and open up access to new technology.
For additional information, contact Hillary Theakston, director of communications, ResMed at (858) 746-2610.