AASM suspends required use of 3 percent hypopnea desaturation scoring criterion

Summary

  • Effective immediately, the AASM 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 continues to recommend scoring hypopneas using the 3 percent criterion; however, it is acceptable for accredited sleep centers to score hypopneas using an oxygen desaturation criterion of 4 percent.
  • AASM accredited sleep centers must document in the patient’s record whether hypopneas were scored using an oxygen desaturation criterion of 3 percent or 4 percent.
  • The AASM Board of Directors continues to evaluate the impact of the scoring manual’s hypopnea scoring criteria.

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 in October 2012, and all AASM accredited sleep centers must begin scoring sleep studies according to the rules in the new scoring manual by Oct. 1, 2013.

The new manual’s hypopnea scoring rule has significant changes, including the criterion that there “is a more than or equal to 3 percent oxygen desaturation from pre-event baseline or the event is associated with an arousal.” However, the coverage policies of a number of insurance payers, including Medicare, continue to require an oxygen desaturation of more than or equal to 4 percent when scoring hypopneas.

Payers can deny payment or deny patients their therapeutic equipment if documentation doesn’t comply with their requirements for diagnostic testing. Therefore, it is critical for sleep centers and durable medical equipment (DME) suppliers to document compliance with payer requirements.

The AASM Board of Directors recognizes that it would be a significant burden for accredited sleep centers to be required to score sleep studies twice, using both the 3 percent and the 4 percent hypopnea desaturation criteria. Therefore, the AASM is suspending indefinitely the requirement for AASM accredited sleep centers to score sleep studies using the 3 percent hypopnea criterion. This change is effective immediately. Other revisions made to the hypopnea scoring rule in 2012 remain in effect; refer to the scoring manual for complete criteria.

The AASM continues to recommend scoring hypopneas using the 3 percent oxygen desaturation criterion described in the scoring manual. However, it is acceptable for accredited sleep centers to score hypopneas using a criterion of 4 percent. AASM accredited sleep centers must document in the patient’s record whether hypopneas were scored using an oxygen desaturation criterion of 3 percent or 4 percent.

The AASM Board of Directors appreciates the feedback received from members and continues to evaluate the impact of the hypopnea scoring criteria.

Comments about the hypopnea scoring criteria can be submitted to the AASM at scoringmanual@aasm.org. Questions or comments about requirements for accredited sleep centers can be submitted to accreditation@aasm.org.

2013-08-27T00:00:00+00:00 August 27th, 2013|Professional Development|