CleveMed Blogs

In this week’s post we decided to write about one of the more popular topics suggested by our readers: definitions of types of sleep studies devices according to CMS (the Center for Medicare & Medicaid Services) and AASM (the American Academy of Sleep Medicine). Hope these quick summaries help in understanding these terms better. CleveMed currently has three devices that fall within these defined categories for the purposes of sleep (Type I - Sapphire PSG, Type II - Crystal Monitor PSG, and Type III - SleepScout).

Definitions according to Center for Medicare & Medicaid Services (CMS) Guidelines

Type I – Attended studies (Sleep studies that are preformed with the oversight of a sleep technologist.) with full sleep staging (Sleep staging monitors the transition through the sleep stages. Traditionally with the use of EEG electrodes that monitor the brain). Type I devices must includes the following channels:

• EEG
• EOG
• ECG/Heart rate
• Chin EMG
• Limb EMG
• Respiratory effort at thorax and abdomen
• Air Flow from nasal canula thermistor and/or X-Flow (AASM re- commends RIP technology
• Pulse Oximetry
• Additional channels for CPAP/BiPap levels, CO2, pH, pressure, etc.

(CPT #95810 Baseline PSG, 95805 MSLT, 95811 Titration)

Type II – Home sleep study test (HST) with type II portable monitor, unattended(Sleep studies that are preformed without the oversight of a Sleep Technologist.); minimum of 7 channels. Type II devices must includes the following channels:

• EEG
• EOG
• ECG/heart rate
• EMG
• Airflow
• Respiratory effort
• Oxygen saturation

(HCPCS #G0398)

Type III – Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels. Type III devices must includes the following channels:

• 2 respiratory movement/airflow
• 1 ECG/heart rate
• 1 oxygen saturation

(HCPCS #G0399, CPT 95806)

Type IV – Home sleep test (HST) with type IV portable monitor, unattended; minimum of 3 channels. Type IV devices must allow channels that allow direct calculation of an AHI or RDI as the result of measuring airflow or thoracoabdominal movement. Alternatively devices that record other information to derive AHI or RDI must be approved by CMS through the review of published peer-reviewed medical literature.
(HCPCS #G0400)

Definitions according to American Academy of Sleep Medicine (AASM) Guidelines

Type I - Monitoring devices perform in-laboratory, technician-attended, overnight polysomnography (PSG) and are discussed separately. (CPT #95810 Baseline PSG Study, CPT #95805 MSLT Study and CPT #95811 Titration Study (CPAP))

Type II – Monitoring devices can perform full PSG outside of the laboratory. The major difference from type 1 devices is that a technologist is not present. These devices are called comprehensive portable devices. (CPT #95807)

Type III – Monitoring devices do not record the signals needed to determine sleep stages or sleep disruption. Typically channels include:

• Four physiologic variables are measured including:
• Two respiratory variables (eg, respiratory movement and airflow)
• Cardiac variable (eg, heart rate or an electrocardiogram)
• Arterial oxygen saturation
• Some devices may have other signals including a monitor to record snoring, detect light, or a means to determine the body position.

(CPT #95806)

Type IV – These devices are called continuous single or dual bioparameter devices. Monitoring devices record one or two variables and can be used without a technician. Typically channels include:

• Arterial oxygen saturation
• Airflow