CPAP Setup
CPAP Insurance Info
BIPAP Insurance Info
CPAP/BIPAP Billing Info for Doctor's Offices
FYI CPAP
- Primary mode of therapy for OSA.
- 70 - 80% of OSA patients set up on CPAP.
- Optimal pressure determined via titration sleep study.
Patient thoroughly educated on principals and goals of CPAP therapy. As well as thorough machine and equipment understanding.
Successful compliance requires proper interface (mask) selection and fit.
- Must avoid: Skin and eye irritations; mask leaks; snoring
- Airway occlusions may indicate possible mouth breather, which may require a full face mask.
Humidification - Can have a major impact on patient acceptance of CPAP therapy.
- Primary treatment for: dry nose, runny nose, nose bleeds, mouth breathers.
- Average usage increased from 4.8 hours without humidity, to 5.3 hours with humidity.
- Heated Humidity - may be used if cool Passover humidity fails. The delivered humidity is greater with heated humidity.
Clinical Interventions
- Non-compliant patients are identified
- Physician updated on interventions (masks, humidity) and patient responses.
- If & when masks and humidity fail, physician consulted regarding: Implementing BIPAP alternative intervention.
Bi-Level (BIPAP) Alternative Intervention
- First alternative to CPAP non-compliance when other forms of intervention (masks, humidity, etc) proved to be ineffective.
- Is indicated when patient is "Non-Responsive" to CPAP Therapy. (does not notice an improvement in their quality of life since beginning CPAP therapy)
- Implement Inspiratory (IPAP) and
Expiratory (EPAP), Independent Pressures.
- Expiratory (EPAP) Pressures may be reduced with BIPAP therapy - in comparison to the required expiratory pressure with CPAP.
- Increases patient comfort, tolerance, acceptance, and compliance.
- Salvage therapy for @ 50% of non-tolerant CPAP patients.
- Physician may establish I/E pressures using the Nighttime Flow Sheet, from the sleep study.
- The sleep tech tracks this information during the sleep study.
- IPAP=Final CPAP setting that obtained acceptable saturations.
- EPAP=Last expiratory pressure required to stop all apneas.