The AASM understands our members’ concerns regarding payer policies not aligning with AASM practice standards. The AASM firmly believes that patients should receive high quality, evidence-based care by appropriately trained and licensed healthcare professionals
The AASM is in touch with payers on a regular basis commenting on and requesting changes to policies so that these policies align with our recommended standards for patient-centered care. The following letters are some examples of how the AASM has worked with various payers to provide guidance on policy making.
Payer Alignment with AASM Recommended Hypopnea Scoring Criteria
AASM’s position statement Polysomnography for Obstructive Sleep Apnea Should Include Arousal-Based Scoring: An American Academy of Sleep Medicine Position Statement, was published in the July 2018 issue of the Journal of Clinical Sleep Medicine. This position statement emphasizes the position of the AASM that the RECOMMENDED AASM Scoring Manual scoring criteria for hypopneas, which includes diminished airflow accompanied by either an arousal or ≥ 3% oxygen desaturation, in adults, be used to calculate the apnea hypopnea index (AHI); the sleep study metric used to measure the severity of sleep apnea. For a more detailed explanation, please click here. For reference, the table below lists which private payer policies align with AASM’s RECOMMENDED hypopnea scoring criteria:
Please note that this is not a complete list of private payers, but will be updated on a monthly basis, as policies are reviewed. AASM members may send policies to firstname.lastname@example.org for review.
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AASM Scoring Manual
Payer Policy Scorecards