Hypopnea Scoring Alignment
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.
Click here to download and personalize a template letter to request that payers consider updating the AHI definition to the one currently recommended by the AASM.
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
Aetna | X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
Anthem Blue Cross Blue Shield
|
X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
|
X | |
|
X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
Blue Cross Blue Shield Minnesota | X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
Blue Cross Blue Shield Massachusetts | X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
Blue Shield of California | X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
Capital Blue Cross | X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
CareCentrix | X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
Cigna | X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
Connecticare | X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
Government Employees Health Association, Inc. | X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
Hawaii Medical Service Association | X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
Highmark Blue Cross Blue Shield | X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
Horizon Blue Cross Blue Shield of New Jersey | X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
Medica | X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
National Imaging Associates Magellan | X | X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
|
X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
|
X |
Private Payer | ≥ 3% O2 Desaturation or Arousal (RECOMMENDED) |
4% O2 Desaturation |
---|---|---|
United Healthcare | X |
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 coding@aasm.org for review.