New Effective Date for Revised Sleep Study Medical Policy

Posted February 16, 2015 

On page 7 of our January 2015 Blue Review,  we published an article to advise you that the Blue Cross and Blue Shield of Illinois (BCBSIL) Medical Policy for Diagnosis and Medical Management of Sleep Related Breathing Disorders (MED205.001) has been revised to establish new criteria and guidance for testing in the diagnosis of Obstructive Sleep Apnea (OSA). The revised policy is intended to align BCBSIL’s Medical Policy with nationally recognized clinical criteria and current industry standards. 

The January 2015 Blue Review article announced that revisions referenced in the article would be effective for dates of service beginning April 15, 2015. Please note that the effective date announced previously has been changed. The revised medical policy will take effect for services rendered on or after May 1, 2015. 

Please refer to the full medical policy in the Standards and Requirements/Medical Policy section for important details. Additional information also will be included in upcoming issues of the Blue Review.  

The article referenced above does not apply to HMO members. 

The BCBSIL Medical Policies are for informational purposes only and are not a replacement for the independent medical judgment of physicians. Physicians are to exercise their own clinical judgment based on each individual patient’s health care needs. Some benefit plans administered by BCBSIL, such as some self-funded employer plans or governmental plans, may not utilize BCBSIL Medical Policy. Members should contact their local customer services representative for specific coverage information.