![]() ![]() Type III: HST with Type III portable monitor, unattended with a minimum of 4 channels.Type II: Home sleep test with type 2 monitor with a minimum of 7 channels that must include EEG, EOG, ECG/heart rate, EMG, airflow, respiratory effort and oxygen saturation.EEG, EOG, ECG/heart rate, chin EMG, limb EMG, respiratory effort at thorax and abdomen, airflow from nasal cannula and pulse oximetry, and additional channels to monitor CPAP, PH, CO2, et cetera. Type 1: Attended studies performed with the oversight of a sleep technologist with full sleep staging and that must include the following channels.CMS also specified the types of HST devices that would be reimbursed.ĬMS guidelines define 4 categories of sleep testing: The guideline specified that the home study must be ordered and supervised by the treating physician. 3 According to the National Coverage Determination that was released that month, a diagnosis of obstructive sleep apnea (OSA) could be made, and the cost of therapy covered on the basis of a clinical evaluation coupled with a home study. In March 2016, the Centers for Medicare and Medicaid Services (CMS), whose reimbursement rules are generally adopted by private insurers, dropped its long-standing opposition to home studies. From left: ApneaLink Air (Resmed, San Diego, CA) Alice NightOne (Philips, The Netherlands) and WatchPAT (Itamar Medical, Israel) Background Telemedicine allows dentists and physicians to collaborate in the care of the patients in real time further amplifying the power and ease of home sleep testing while meeting quality guidelines. There are several different ways dentists currently incorporate HST into their practices. 2 The technology for testing continues to evolve with increased accuracy and reduced cost. This is particularly significant when one considers the roughly 80% of patients with sleep apnea who remain undiagnosed. Home sleep testing has improved access to care, expedited diagnostic pathways, and provided a wider reach to the population. While not appropriate for diagnosing many of the more complex sleep disorders, HST is safe, effective, and it provides valid data for the diagnosis of uncomplicated obstructive sleep apnea. ![]() 1 Home sleep testing (HST) is a disruptive technology that has changed the management of sleep apnea and reduced some of the barriers to care.
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