ok- stupid me- I found the answer to this. But, another question- in the LCD it states that the AHI or RDI must be over 15. On this person's sleep study, the AHI is 3, but the RDI 16.4. Which do I use to determine elibility?
That's strange! The AHI (Apnea / Hypopnea Index) was the old language then RDI (Respiratory Disturbance Index) described a broader spectrum. But most scorers treat them in such a way in the study that the numbers are exactly the same. You could use the RDI to qualify the patient because the AHI puts them in the "normal" category and definitely wouldn't qualify them for a PAP.
As a side note, I'd call the sleep lab to find out why such a difference in the figures. Wow!
I have been looking into this further, and have discovered this-
the AHI is the number of hypopneas, while the RDI is the number of overall sleep distrubances, so they can indeed be different. So our respiratory therapist was wrong!
An RUL - Reasonable Useful Lifetime for a CPAP doesn't require a new sleep study - though, it can be useful to refine any changes in need/pressure to effectively treat the SDB.
All that is required is a face to face physician visit that documents continued use and need of the device. It would be useful to have some details about the overall compliance and percieved benifits that the patient might or might not be deriving from therapy, but then I'm just a Dreamer!
CPAP replacement
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