Thursday, March 13, 2008

The Key Line in the CMS decision

Please see my post earlier today for the full CMS decision on Home Testing.

I found this line interesting:

unattended home sleep monitoring device of Type IV, measuring at least three channels

I only have a basic understanding of the main Type 4 device on the market, the Resmed ApneaLink. My understanding is that it utilizes a nasal pressure transducer. I just googled it and came up with this site:

It looks like there is an optional oximeter available, that adds 2 channels (pulse and oximetry) to the nasal pressure transducer channel, giving the required 3 channels.

Are most doctors who are currently using the Resmed ApneaLink also using the optional oximeter??? If anyone has some info about this device, please leave a comment. Thanks.


KySleep said...

Dr. Rack, I have read your posts and you are dead on! I have been in the field since 1991 and this seems to me as a near death sentence. The only line in the entire CMS decision that to me offer a slim hope for practioners, and technologist is that re-eveluation will be done, to paraphrase. As for the HST devices, regardless of the cost the reimbursements are so rediculously low that viable testing is all but impracticle. If Dr. Dement, the AASM and many others thought there was a void in testing as it stood...I don't see any way my business can survive long term. I have already called several private payer sources and they too have levels of payment that would not cover the replacement of a thermistor, etc...much less a level that could provide income. So, how will HST's provide a greater coverage area if no practice can reasonably conduct the testing. Not to mention that CMS did not make any specific treatment guidelines or that these test be performed,read or even conducted by professional in sleep medicine. Its a loss, especially to the AASM, which CMS didn't use any language that was in the AASM's opinion to CMS. This is a large kick in the head, and as one your post, a stab in the back.

Michael Rack, MD said...

kysleep, I agree.
I don't have any great solutions.

thanks for reading.