Due to communication between the AASM Payer Policy Review Committee (PPRC) and representatives from Blue Cross Blue Shield and Blue Care Network of Michigan, the payer has updated its policy and now accepts the AASM RECOMMENDED hypopnea scoring criteria.

The PPRC has been communicating with private payers to share the recent AASM publication, Polysomnography for Obstructive Sleep Apnea Should Include Arousal-Based Scoring: An American Academy of Sleep Medicine Position Statement, which encourages scoring hypopneas associated with EEG-based arousals, with or without oxygen desaturation, or including respiratory effort-related arousals (RERAs). The AASM RECOMMENDED hypopnea scoring criteria, which includes diminished airflow accompanied by either an arousal or ≥3% oxygen desaturation, can be used to calculate the apnea hypopnea index or RERAs can be used when calculating the respiratory disturbance index.

The PPRC continues to advocate on behalf of AASM members by reaching out to payers that do not currently accept arousal-based scoring criteria, encouraging them to update their policies. Learn more about the work of the PPRC on the Private Payers page of the AASM website.

All questions regarding this initiative can be sent to coding@aasm.org.