PAP Qual Flashcards
(32 cards)
What are the 3 screening questionnaires
STOP-BANG
Berlin
Epworth
STOP-BANG
Assesses snoring, wake time sleepiness, leading indicators blood pressure, BMI, age, neck size, and gender. High risk equals yes to 5+ questions
Berlin
3 categories w/ total of 10 questions specific to OSA. Snoring, wake time, sleepiness fatigue history of obesity and hypertension. High risk presents symptoms in 2+ categories
Epworth
Assess general lvl of sleepiness. 8 questions Assessing the probability of falling asleep during low activity situation’s. Abnormal score is 12 to 24
Diagnostic PSG in lab
12 channels with 22 wires that detect brain activity, eye movement, muscle movement, respiratory airflow, pulse oximetry and heart rate
Types of DX study’s
Medicare requires a minimum of two hours. Titration study.
Split night study.
MSLT.
HST
Four channel.
Heart rate.
Oxygen saturation. Respiratory flow. Respiratory effort.
HST providers
VirtuOx
Blackstone
They ship HST to pt.
Mild OSA
AHI or RDI of 5 to 14.
Needs additional documentation, c/o excessive daytime sleepiness, HTN,abnormal heart rate
AHI
Apnea hypopnea index
Moderate OSA
AHI or RDIR 15 to 30 events per hour
Servers OSA
AHI or RDI of greater than 30 events per hour
Continuous positive airway pressure
Measures in centimeters of water pressure, CM H2O
Auto CPAP
Auto adjust based on patient’s airway dynamic. Set a minimum and maximum pressure
Bi-level airway pressure.
RAD - respiratory assist device
Two pressures.
Higher inspiratory pressure.
Lower expiratory pressure.
Bi-Level w/ Backup Rate
S/T
To ranges of pressure settings. Minimum and maximum. Inspiratory pressure setting. Expiratory pressure setting. Delivers a guaranteed number of breaths
ASV
Adaptive servo ventilation
Adapts to patients breathing pattern. Very sophisticated
Coverage period’s
Initial coverage. First three months of therapy. Continued coverage. Be on the first three months
F2F requirements
F2F Prior to ss. C/O OSA sx
Duration of symptoms.
One of the questionnaires
Upper airway evaluation. Next circumference. BMI
SS interpretation by:
Certification and sleep medicine by a BSM
Sub specialist certification and sleep medicine by a BSM/AOA
Active staff member of a sleep center accredited by AASM,ACHC, or a joint commission
Required AHI for treatment
Greater to or equal to 15 events per hour. Minimum 30 events guaranteed to cover
AHI + c/o or do
Greater than or equal to five and less than equal to 14 events per hour. Minimum of 10 events. EDS. Impaired cognition, Mood disorders, insomnia, HTN, ischemic heart disease, or history of stroke
Bi- level w/o back up rate
CPAP tried and failed or proven ineffective. Physician documents proper mask. Appropriate pressure setting. Lower pressure fail to control improve or reduce AHI
Continuing coverage of pap therapy
Reevaluate between 31 to 90 days of initial therapy. Documentation of clinical benefits of therapy i.e. down low. Symptoms of OSA improved. 4+hrs, 70% of consecutive 30 days within first three months
