Obstructive Sleep Apnea in Adults

Attended full‑channel nocturnal polysomnography (Type I) is medically necessary for adults (≥18) with symptoms suggestive of OSA when used in a comprehensive sleep evaluation and the member has one or more listed indications (e.g., comorbidities that degrade portable monitoring such as moderate–severe pulmonary disease with nocturnal O2 use or daytime hypercapnia, neuromuscular disease, post‑stroke respiratory effects, or epilepsy with diagnostic uncertainty). Studies/devices that do not measure AHI and oxygen saturation (eg, Biancamed SleepMinder, SNAP <3 channels, ApneaLink without airflow—ApneaLink Plus with airflow meets criteria), testing for snoring alone, consecutive‑night repeat home testing, and repeat testing solely for CPAP replacement (unless other policy indications for repeat testing apply) are not medically necessary.

"Continuous Positive Airway Pressure (CPAP) devices and accessories — HCPCS E0601 and listed masks/interfaces/accessories (A7027–A7046, A7037–A7039, E0561–E0562, etc."