Private Payer Communications
The AASM has sent many letters to private payers for Advocacy purposes over the years. Some communications are campaigns during which multiple payers are contacted about the same issue. Some of these include:
- Treatment with Positive Airway Pressure Therapy
- Alignment with the AASM Hypopnea Scoring Criteria
- Actigraphy reimbursement
Additional communications focus on specific member inquiries and/or concerns with payer policies. Some of the most recent communications are included below.
- Aetna – Automatic Addition of 26 Modifier to 95806 (5/4/2022)
- Anthem BCBS Kentucky – Telehealth policy change (4/15/2022)
- United Healthcare – Medical Treatment Policy (9/17/2021)
- United Healthcare response (10/9/2021)
- United Healthcare – Support for APP Referrals (10/14/2020)
- United Healthcare response (1/13/2021)
- Medica – PSG for PLMD and Parasomnias in Pediatric Patients (8/9/2019)
- QualChoice – Allowing for AASM accreditation (8/13/2018)
- Cigna – Daytime Sleepiness Requirement for Sleep Studies (1/18/2017)
- Horizon Blue – NovaSom as sole HSAT provider (6/28/2016)
- BCBS Nebraska – Incorrect society citation (7/2016)
- Anthem – Policy inconsistencies with AASM guidelines and correct coding (10/5/2016)
- BCBS Alabama – Expanding acceptable Board certifications (11/10/2016)
We encourage members to send policies that do not align with AASM clinical practice guideline recommendations or accreditation standards to coding@aasm.org, for review.