Respiratory Assist Devices CPAP-BiPAP - Health Plan of Nevada

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APPLICABLE CODES CPT ® Code Description 94660 Continuous positive airway pressure ventilation (CPAP), initiation and management 94799 Unlisted pulmonary service or procedure CPT ® is a registered trademark of the American Medical Association HCPCS Codes E0470 E0471 E0601 E0561 E0562 Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e. g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) Respiratory assist device, bi-level pressure capability, with backup rate feature, used with noninvasive interface, e. g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) Single level continuous positive airway pressure device Humidifier, non-heated, used with positive airway pressure device Humidifier, heated, used with positive airway pressure device REFERENCES Ballester E, Badia JR, Hernandes L, et al. Evidence of the effectiveness of continuous positive airway pressure in the treatment of sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 1999;159:495-501. Barbe R, Mayoralas LR, Duran J, et al. Treatment with continuous positive airway pressure is not effective in individuals with sleep apnea but no daytime sleepiness. Ann Intern Med 2001;134:1015- 1023. Bradley TD, Phillipson EA. Pathogenesis and pathophysiology of the obstructive sleep apnea syndrome. Med Clin NA 1985;69:1169-1185. Calverley PM. Nasal CPAP in cardiac failure: case not proven". Sleep 1996 Dec;19 (10 Suppl):S236-9. Centers for Medicare & Medicaid Services (CMS) NCD for Continuous Positive Airway Pressure (C- PAP) Therapy for Obstructive Sleep Apnea (OSA) (NCD 240.4) Effective March 13, 2008. Accessed August 2010. Centers for Medicare & Medicaid Services (CMS). DME MAC Noridian Administrative Services (19003) LCD for Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea (L171) Effective: October 01, 1993. Updated: March 07, 2010. Revision Eff: April 01, 2010. Accessed August 2010. Respiratory Assist Devices_CPAP-BiPAP Page 6 of 9
D’Ortho MP, Grillier-Lanoir V, Levy P, et al. Constant vs automatic continuous positive airway pressure therapy. Chest 2000;118:1010-1017. Dimsale JE, Loredo JS, Profant J. Effecti of continuous positive airway pressure. Hypertension 2000;35:144-147. Engleman HM, Kingshott RN, Wraith PK, et al. Randomized placebo-controlled crossover trial of continuous positive airway pressure for mild sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 1999;159:461-467. Engleman HM, Martin SE, Deary IJ, Douglas NJ. Effect of CPAP therapy on daytime function in patients with mild sleep apnea/hypopnoea syndrome. Thorax 1997;52:114-119. Faccenda JF, Mackay TW, Boon NA, Douglas NJ. Randomized placebo-controlled trial of continuous positive airway pressure on blood pressure in the sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 2001;163:344-348. Fox GA, Lam CJ, Darragh WB, Neal AM, Inman KJ, Rutledge FS, Sibbald WJ. Circulatory sequelae of administering CPAP in hyperdynamic sepsis are time dependant J Appl Physiol 1996 Aug;81(2):976-84. Gonsales S, Thompson D, Hayward R, Lane R. Treatment of obstructive sleep apnea using nasal CPAP in children with craniofacial dysostoses. Childs Nerv Syst 1996 Nov;12(11):713-9. Guilleminault C. Obstructive sleep apnea. Med Clinics NA 1985;69:1187-1203. Health Care Financing Administration. CIM 60-17 Continuous positive airway pressure (CPAP) 1986. Heinzer R, Gaudreau H, Decary A, et al. Slow-wave activity in sleep apnea patients before and after continuous positive airway pressure treatment. Chest 2001;119:19807-1813. Henke KG, Grady JJ, Kuna ST. Effect of nasal continuous positive airway pressure on neuropsychological function in sleep apnea-hypopnea syndrome. Am J Respir Crit Care Med 2001;163:911-917. Hudgel DW, Fung C. A long-term randomized, cross-over comparison of auto-titrating and standard nasal continuous airway pressure. Sleep 2000;23:645-648. Jokic R, Klimaszewski A, Sridhar G, Fitzpatrick MF. Continuous positive airway pressure requirement during the first month of treatment in patients with severe obstructive sleep apnea. Chest 1998;114:1061-1069. Jokic R, Klimaszewski A, Crossley M, et al. Positional treatment vs continuous positive airway pressure in patients with positional obstructive sleep apnea syndrome. Chest 1999;115:771-781. Respiratory Assist Devices_CPAP-BiPAP Page 7 of 9
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