Obstructive Sleep Apnea in Adults - Medical Clinical Policy Bulletins

Coverage for adults diagnosed with obstructive sleep apnea (OSA) includes attended full-channel nocturnal polysomnography (NPSG) for accurate diagnosis when symptoms are present and a comprehensive evaluation is warranted. Key requirements include having medical conditions like pulmonary disease, stroke, epilepsy, or chronic opioid use, which further necessitate monitoring for OSA, while limitations exclude coverage for unrelated diagnoses and restrict unattended sleep studies without suggestive symptoms. Documentation of diagnosis, clinical justification, and specific symptoms are essential to secure coverage.

"Covered for adults diagnosed with obstructive sleep apnea as per clinical guidelines."

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