![]() Therefore, a follow-up sleep study would be required to confirm or exclude the diagnosis of OSA, regardless of the results of pulse oximetry screening. The sensitivity and negative predictive value of pulse oximetry is not adequate to rule out OSA in patients with mild to moderate symptoms. Pulse oximetry alone is not an efficient method of screening or diagnosing patients with suspected obstructive sleep apnea (OSA). The report explained that, during asthma exacerbations, the degree of hypoxemia may not accurately reflect the underlying degree of ventilation-perfusion (V-Q) mismatch. Home pulse oximetry is also indicated when there is a need to monitor the adequacy of SaO2 or the need to quantitate the response of SaO2 to a therapeutic intervention.Ī National Heart, Lung and Blood Institute/World Health Organization Global Asthma Initiative Report concluded that pulse oximetry was not an appropriate method of monitoring patients with asthma. The units used in the home are usually small, portable hand-held devices, though they can be larger, stationary machines.įor patients on long-term oxygen therapy, pulse oximetry arterial oxygen saturation (SaO2) measurements are unnecessary except to assess changes in clinical status, or to facilitate changes in the oxygen prescription. It may be considered medically necessary to assist the physician in determining the correct flow of supplemental oxygen, monitor changes in O2 sat during exercise and assist with management of home ventilators. Home oximetry may be used to monitor the O2 sat in the blood of individuals with known or suspected heart disease or many other circulatory or lung disorders. A sensor is placed on a finger, toe or ear and uses light to estimate the oxygen saturation in the arterial blood the sensor is connected by a wire to a monitor, which then displays both the oxygen saturation (O2 sat) and the heart rate. They are often also referred to as "pulse oximeters" because they also measure and record an individual’s heart rate. Oximeters are noninvasive monitors that measure the oxygen saturation of blood. See also CPB 0004 - Obstructive Sleep Apnea in Adults, CPB 0479 - Respiratory Devices: Incentive Spirometers, Vaporizers and Intermittent Positive Pressure Breathing Machines, and CPB 0572 - Home/Ambulatory Spirometry. When used alone as a screening/testing technique for suspected obstructive sleep apnea.Predicting the need of adenotonsillectomy in children.Maintenance or continuous monitoring (other than for persons on a ventilator).Evaluation of exertional desaturation in individuals with COVID-19.Note: Capnography is considered incidental to anesthesia or sedation services and is not separately reimbursed.Īetna considers the use of home pulse oximetry experimental and investigational for all other indications, including the following because its effectiveness for these indications has not been established:Įvaluating and teaching continuous positive airway pressure (CPAP) Aetna considers capnography experimental and investigational for pre-screening of sleep-disordered breathing after stroke, and assessment of prognosis following cardiac arrest. Home pulse oximetry for indications other than those listed above may be considered medically necessary upon medical review.Īetna considers capnography (end-tidal carbon dioxide (PETCO2) monitoring) medically necessary for monitoring of members with congenital central alveolar hypoventilation syndrome. Pulse oximetry can be used in conjunction with infant home apnea monitoring for information on infant apnea monitors, see CPB 0003 - Apnea Monitors for Infants. For interstage monitoring of children undergoing the Norwood procedure for hypoplastic left heart syndrome.įor information on the use of pulse oximetry in periodically re-assessing the need for long-term oxygen in the home, see CPB 0002 - Oxygen.When weaning the individual from home oxygen or. ![]() Short-term (one month) monitoring when a change in the individual's physical condition requires a physician-directed adjustment in the liter flow of their home oxygen needs or
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