Sleep Apnea Diagnosis and Treatment in Adults

Sleep apnea refers to sleep‐disordered breathing due to the recurrent collapse of pharyngeal tissues resulting in snoring, fitful sleep, and daytime somnolence. Risk factors for Obstructive Sleep Apnea (OSA) include male gender, age, obesity, airway characteristics, familial/genetic predisposition, smoking, and alcohol consumption. The majority of patients with OSA are asymptomatic, unaware of their sleep disordered breathing and associated health risks.

Coverage decision: Covered with conditions (Effective date: June 1, 2014).

Note: Diagnosis and treatment of sleep apnea may be used only for care of a condition accepted on the claim. Sleep apnea is unlikely to be related to any occupational injury or disease and is therefore not expected to be an accepted condition on an L&I claim.

Authorization requirements


Is authorization required?

How do I get pre-authorization?

Yes

L&I (State fund):
Complete the Preauthorization Form and fax to (360) 902-4567

For Self-insured:
Contact the employer or its third party administrator

 

Regulatory authority and related information

 

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