Most sleep professionals are aware that Medicare now requires objective documentation of compliance with CPAP during the first 3 months of use for continued coverage of CPAP. During a consecutive one month period during the first 3 months, the patient needs to use CPAP at least 4 hours per night for 70% of the nights.
When looking at compliance reports from Respironics CPAP machines, I used to look at the % result of "Percent of Days with Usage greater than or equal to 4 hours". However, days in which CPAP is not used at all are not included in calculating this figure.
To get the correct "Medicare %", you need to multiply "Percent Days with Device Usage" by "Percent of Days with Usage greater than or equal to 4 hours."
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edit (4/9/09) When doing this calculation, make sure you are using a download report for a 30 day consecutive period (see comments)
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This problem was pointed out to a Respironics representative, and I think we will soon be seeing a more user-friendly compliance download report from Respironics.
Wednesday, April 08, 2009
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