Sleep Management Guidelines

Covers diagnostic HSAT and attended in‑lab PSG (with split‑night or two‑night protocols), MSLT/MSLT, MWT, PAP initiation/titration (E0601, E0470, E0471), oral appliance and hypoglossal nerve stim evaluations, pediatric PSG and repeat testing per-listed indications; excludes/considers experimental stand‑alone actigraphy, PAP‑NAP, listed devices (e.g., iNAP, eXciteOSA, BongoRx, ULTepap), and nonspecific DME codes (CPT 94799/E1399). Key requirements: a comprehensive clinical evaluation within 60 days plus a validated sleep questionnaire (or proxy), HSAT technical adequacy (≥4 hours oximetry and flow), specified physiologic/comorbidity criteria for in‑lab testing (e.g., awake PaCO2/ETCO2 >45 mmHg or venous PCO2 ≥50 mmHg or HCO3− ≥27), MSLT only after a full‑night PSG with ≥6 hours sleep, and PAP continuation/replacement requires device download‑verified compliance (≥4 hours/night on ≥70% of nights over a consecutive 30‑day period) and regular follow‑up.

"Testing not indicated for evaluation of insomnia in the absence of symptoms or provider concern for another sleep-fragmenting disorder."