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.
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12 comments:
Multiplying won't work either because it actually has to be 70% of a 30d CONSECUTIVE period within the 90 day period...
Thanks for pointing that out, Mark.
I should havee specified that you need to be looking at a 30 day download report.
I first off, would like to say how much i am impressed with the site. I was wondering if i could seek your professional advice on a post i just did regarding medications for sleep. I was wondering if this information was pretty much in sync with a doctors opinion and if there are any other types of medications i was missing.
http://drinsomnia.blogspot.com/
Thanks for your comments, sharemyself.
Unfortunately, I disagree with a lot of your blog. Antidepressants are not addictive. Some people can take benzodiazepines without increasing the dose. Antihistamines such as benadryl are ok for short term use for insomnia, but tolerance quickly develops. Benadryl can also cause side effects such as confusion and constipation.
You may want to add Rozerem, a melatonin agonist
I think Resmed's compliance reports are better. They now have a device that connects to the back of pap machines and sends compliance data on a daily basis via the cellular networks. We are looking to start using these devices. Now for sending our sleep test results and these compliance reports to physicians, we have started to use a online document delivery portal called MedMinister.com . Referring physicians really like accessing patient test results electronically via Medminister.com, and it has helped us attract more referring physicians.I really recommend it to all sleep labs. Not having to fax has been amazing.
Thanks for the tip, Rick. I am in the process of enrolling in the Respironics Encore Anywhere program, which sounds similar to the Resmed medminister. I'll check out the Resmed site.
Actually MedMinister.com is its own company Michael. What I mentioned with Resmed was that they have this device called ResTraxx that is by far an easier approach to patient cpap compliance than encore anywhere. We actually looked at both. The problem with encore is that the patient must have high speed internet connection at their home and the Cpap provider must network the cpap device to the patient’s internet, which is hard and very time consuming. You practically need your own Geek Squad, LOL. But with resmed’s ResTraxx you just connect the cell phone size device to the back of the cpap and your done. Compliance reports will then be sent to us via the cell phone networks to the restraxx web interface. Then we save the reports as PDF and use MedMinister.com to send them to the physicians. The great thing about MedMinister.com is that it’s not limiting us to a respironics device or resmed device or any other brand. With encore anywhere, they only let you use it for respironics devices, which are not the only devices we use. We use MedMinister to electronically send compliance reports, CMNs and our interpreted sleep test results to physicians (it also has an integrated faxing option). The physician’s office gets an email notification when a new file has been sent to them by us. Then they securely login to our labs MedMinister portal and access the reports from anywhere they’d like. Many HME and DME companies use it too I heard. The physicians that refer patients to us where really impressed when they saw our MedMinister portal. Plus it’s saving us something like $8,000 a year in material and labor.
Wow I think I’ve written too much here. Anyhow, thanks a lot for your blog I’ve always found it to be very useful and informative, please keep it up. Here is the link to MedMinister’s website http://medminister.com
Thanks, Dr. Jacobson. I added a link to your blog to my rebel doctor blog
Hi, I am currently looking into narcolepsy following the birth of a narcoleptic lamb about six weeks ago. Not too many references to those to be found anywhere, but a similar problem exists in some breeds of horses. One point that has been raised is the apparent correlation between narcolepsy in some of these animals and premature birth. I was looking for any references to this in humans I noticed that premature babies needed more REM sleep but wondered if there were any transient or short term problems with narcolepsy in newborns? any info would be most helpful;
thank you
Kanisha,
I am not aware of any transient or short term problems with narcolepsy in newborns
I read your blog and found the effective and highly productive ideas about respironics cpap machines ....thanks
respironics cpap machine
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