CPAP/BIPAP Documentation Checklist
- Patient demographics
- Face to face chart notes -----prior to PSG
- PSG or Split Study (also titrated study if ordering BIPAP)
- Rx with description of items ordered
- **IF AHI is less than 15 the patient must also have one of the following diagnosis indicated in their progress notes to qualify: excessive daytime sleepiness, hypertension, impaired cognition, mood Medicare only considers long term oxygen therapy for payment; short term therapy for an acute condition is not a covered benefit.
- disorders, insomnia, ischemic heart disease, history of stroke
- If home test includes sleep test instructions and test
For ordering BIPAP ALL the above applies and the following is also required:
- A Cpap has been tried and proven ineffective based on a therapeutic trial conducted in either facility or in a home setting
- Ineffective is defined as documented failure to meet therapeutic goals using a Cpap during the titration portion of a facility-based study or during home use (i.e. proper mask fitting and selection with appropriate pressure settings)
- A NEW Face to Face is required for Bipap if the patient has used a Cpap for more than 3 months