Wednesday, September 24, 2008

DME Companies Left Out of Home Testing

It appears that Durable Medical Equipment companies have been left out of home testing by most of the regional Medicare carriers.
Here is part of the Local Coverage Determination for Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea (L11518) for Cigna Government Services:

No aspect of an HST, including but not limited to delivery and/or pickup of the device, may be performed by a DME supplier. This prohibition does not extend to the results of studies conducted by hospitals certified to do such tests.

The LCD also states:

The test must be ordered by the beneficiary’s treating physician and conducted by an entity that qualifies as a Medicare provider of sleep tests and is in compliance with all applicable state regulatory requirements.

I interpret this section is not allowing individual doctors to perform home testing in the area covered by Cigna Government Services. It seems that home testing must be performed by a sleep center/sleep lab.

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