We reviewed exertional oxygen in the November newsletter; this month we will review nocturnal oxygen funding.
SAIL Nocturnal Oxygen Policy States:
- Patients must not have been hospitalized for a cardiorespiratory event or had an exacerbation or change of treatment in the 30 days prior to testing.
- Nocturnal funding applications should only be made for patients whose blood gas or oximetry results do not show qualification for continuous oxygen.
- Nocturnal oximetry testing shall be done both on room air and with supplemental oxygen. Both completed tests and the underlying diagnosis must be included with the application for funding.
- Patients shall demonstrate nocturnal hypoxemia through saturations ≤87% on overnight oximetry for a period of more than 30% of the test time. Measured saturation with the application of oxygen therapy should show evidence of significant improvement.
- Oxygen is not recommended as a single intervention for sleep apnea and may not be funded.
- Benefits may be considered on an exceptional basis when prescribed by a respirologist. Documentation of polysomnography results or other supporting evidence must be provided. Use of oxygen must show evidence of significant improvement.
SAIL Coverage: - Funds a concentrator.
- Initial coverage is for up to one year.
However, a person who may appear to meet criteria may be denied long-term coverage (i.e. be required to do further testing) if our consultant determines, for example:
- That the testing shows evidence of obstructive sleep apnea
- That the client/patient should be referred for a sleep study
- That the patient uses a flow generator (e.g. CPAP) but has not been tested while wearing the device.
If someone receives nocturnal funding and already has existing exertional funding, please ensure both are checked off on the SAIL application (or a note made that client already has funding). If a client gets both nocturnal and exertional funding, they will be considered to have 'Continuous' funding in the SAIL program. For questions about any of the above, please email oxygentest@lungsask.ca or call 306-370-9012. NIHB Nocturnal Oxygen Policy States:- NIHB's nocturnal desaturation for adults with sleep-disordered breathing initial coverage period is for up to 3 months. Subsequent renewal requests will be considered for a period of 12 months with different requirements from the initial coverage period
- Room air testing demonstrating nocturnal desaturation less than 89% for 30% of the night
- Sleep-disordered breathing must be ruled out
- Persistent hypoxemia demonstrating nocturnal desaturation less than 89% for 30% of the night that is not corrected with positive airway pressure (PAP)* therapy
- Level I, III, or IV sleep study with interpretation by a physician with expertise in sleep medicine that demonstrates improvement when using oxygen with a positive airway pressure (PAP) device
For questions about NIHB funding, email sasknihbmedicalsuppliesandequipment@sac-isc.gc.ca or speak to your local home oxygen provider. |
