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PAP sleep > PAP Qual > Flashcards

PAP Qual Flashcards

1
Q

What are the 3 screening questionnaires

A

STOP-BANG
Berlin
Epworth

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2
Q

STOP-BANG

A

Assesses snoring, wake time sleepiness, leading indicators blood pressure, BMI, age, neck size, and gender. High risk equals yes to 5+ questions

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3
Q

Berlin

A

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

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4
Q

Epworth

A

Assess general lvl of sleepiness. 8 questions Assessing the probability of falling asleep during low activity situation’s. Abnormal score is 12 to 24

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5
Q

Diagnostic PSG in lab

A

12 channels with 22 wires that detect brain activity, eye movement, muscle movement, respiratory airflow, pulse oximetry and heart rate

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6
Q

Types of DX study’s

A

Medicare requires a minimum of two hours. Titration study.
Split night study.
MSLT.

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7
Q

HST

A

Four channel.
Heart rate.
Oxygen saturation. Respiratory flow. Respiratory effort.

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8
Q

HST providers

A

VirtuOx
Blackstone
They ship HST to pt.

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9
Q

Mild OSA

A

AHI or RDI of 5 to 14.

Needs additional documentation, c/o excessive daytime sleepiness, HTN,abnormal heart rate

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10
Q

AHI

A

Apnea hypopnea index

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11
Q

Moderate OSA

A

AHI or RDIR 15 to 30 events per hour

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12
Q

Servers OSA

A

AHI or RDI of greater than 30 events per hour

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13
Q

Continuous positive airway pressure

A

Measures in centimeters of water pressure, CM H2O

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14
Q

Auto CPAP

A

Auto adjust based on patient’s airway dynamic. Set a minimum and maximum pressure

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15
Q

Bi-level airway pressure.

RAD - respiratory assist device

A

Two pressures.
Higher inspiratory pressure.
Lower expiratory pressure.

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16
Q

Bi-Level w/ Backup Rate

S/T

A

To ranges of pressure settings. Minimum and maximum. Inspiratory pressure setting. Expiratory pressure setting. Delivers a guaranteed number of breaths

17
Q

ASV

Adaptive servo ventilation

A

Adapts to patients breathing pattern. Very sophisticated

18
Q

Coverage period’s

A

Initial coverage. First three months of therapy. Continued coverage. Be on the first three months

19
Q

F2F requirements

A

F2F Prior to ss. C/O OSA sx
Duration of symptoms.
One of the questionnaires
Upper airway evaluation. Next circumference. BMI

20
Q

SS interpretation by:

A

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

21
Q

Required AHI for treatment

A

Greater to or equal to 15 events per hour. Minimum 30 events guaranteed to cover

22
Q

AHI + c/o or do

A

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

23
Q

Bi- level w/o back up rate

A

CPAP tried and failed or proven ineffective. Physician documents proper mask. Appropriate pressure setting. Lower pressure fail to control improve or reduce AHI

24
Q

Continuing coverage of pap therapy

A

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

25
Q

Three month trial failed requal

A

New F2F. Repeat SS. Diagnostic ,titration, or split night

26
Q

PAP to Bi- level

A

Call find reasons CPAP tried found and effective. CPAP used for 3+ months and change to buy level will start a three month trial again

27
Q

Additional dx for bi level

A

Restrictive thoracic disorder
COPD
Central or complex SA
Hypoventilation syndrome

28
Q

Restrictive Thoracic disorder documentation

A

Neuromuscular disease. Severe thoracic cage abnormalities

29
Q

Bi-Level

Qualifiers for restricted Thoracic disorder

A

1: ABG awake Prescribed FI02. -PaCO2 <=45 MM Hg
2: O/O <=88% for greater than five minutes W/ +2 hours

3: neuromuscular disease only
Max inspiratory pressure,
-MIP < 60 CM H2O. Forest vital capacity. FVC <50% of predicted

30
Q

Bi-level Sever COPD

A

1- ABG PaCO2 >= 52 MM Hg
2- O/O <=88% - >=5 - 2+hrs of testing.
3- CPAP therapy rules out

31
Q

Bi-level Central/complex SA

A

PSG in lab
DX of CSA
Results significant improvement hyperventilation. While breathing prescribed FiO2

32
Q

Bi-level Hypoventilation syndrome

A

ABG done during sleep or immediately upon waking a PaCO2 >= 7 MM Hg
SS O2 Saturation. SAT <=88% ->=5, 2+hrs testing and AHI <5

PAP sleep (1 decks)

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