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I was diagnosed with severe sleep apnea approximately 12 years ago and have used a CPAP ever since. In 2015, I retired and am now covered by medicare and a supplemental plan. Several months ago new supplies were needed and I contacted medicare. Since I had not had a sleep study within 3 years, they said I needed one. Last August I underwent the sleep study and then a titration. Results confirmed sleep apnea, though milder and a new setting of 9.New findings: Mild obstructive sleep apnea. Respiratory events were associated with significant oxygen desaturations (nadir of 89%) on room air. Although, overall apnea-hypopnea index (AHI) was in mild range, the supine AHI is in the severe range. The AHI may be underestimated due to lack of REM-supine sleep. I'm working with a supply provider who is approved by medicare. Now the provider states that medicare won't likely approve any supplies unless 2 additional conditions are met. The first is to obtain the notes from my PCP for the visit when the new study was ordered. The problem is there was no visit because I called his office and he ordered the study as I requested. It was all done via phone. And the provider states that since my AHI is in the mild range a secondary diagnosis is necessary for medicare to approve the supplies. Since I don't have either of the above, I'm stuck in limbo with no supplies. If anyone out there has experience with a similar situation your assistance would be appreciated. Thanks!
