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Why are there several different effective dates in the PAP Device policy?

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Why are there several different effective dates in the PAP Device policy?

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The national coverage determination (NCD) became effective on March 13, 2008. The NCD required a clinical evaluation and demonstration of improvement in OSA symptoms in the first 12 weeks of PAP use. It also allowed the use of home sleep tests to qualify the patient for a PAP device. As is often the case, the NCD requirements needed further definition and explanation; therefore, those additional guidelines for coverage, coding and payment were included in the DME MAC LCD. A prospective effective date was given to allow compliance with those criteria.

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