Claims data shows that the sleep medicine specialty code is only rarely used by providers of sleep medicine services. The sleep field is therefore not experiencing the benefits of having our own specialty code in the Medicare system. If your practice is at least 50 percent sleep, the AASM encourages you to make sleep medicine your primary specialty in the Medicare provider enrollment system.

A final rule published Aug. 4 in the Federal Register by the U.S. Department of Health and Human Services establishes that the compliance date for the International Classification of Diseases, 10th Revision (ICD-10) is Oct. 1, 2015.

Physician Payment Sunshine Act requires manufacturers of drugs, devices, biologicals or medical suppliers to report annual certain payments or transfers of value to physicians and teaching hospitals. This data will become public on Sept. 1, 2014. Physicians do have the opportunity to review reports on payment and transfers of value and have the right to challenge reports that may be false, inaccurate or misleading. 

The Centers for Medicare & Medicaid Services (CMS) has proposed adding capnography to the practice expense for pediatric polysomnography codes 95782 and 95783 starting in 2015. The proposal is a direct result of AASM advocacy efforts. This proposal is outlined in the 2015 Medicare Physician Fee Schedule Proposed Rule.

On May 28 the Centers for Medicare & Medicaid Services (CMS) published a proposed rule recommending a prior authorization process for certain durable medical equipment including both CPAP and RAD. On July 8, the AASM submitted a comment letter discouraging CMS from implementing the proposed rule.

On May 28 the Centers for Medicare & Medicaid Services (CMS) published a proposed rule recommending a prior authorization process for certain durable medical equipment, prosthetics orthotics and supplies (DMEPOS). The rule identifies a “master list” of DMEPOS items of a certain price point that are frequently subject to unnecessary utilization – both CPAP and RAD are identified on the master list. CMS will implement prior authorization for a limited number of DMEPOS items from the master list.

On May 1 the Centers for Medicare & Medicaid Services (CMS) stated that it expects to “release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning October 1, 2015.”