Instant Diagnostic Systems, Inc.

Instant Diagnostic Systems, Inc.
Independent Diagnostic Testing Facility - NPI: 1922017516
1740 4th Ave. SE, Suite A, Decatur, AL 35601
PO Box 2449, Decatur, AL 35602
Phone: 800-355-0691 Fax: 888-771-5159
Page 1 of 4
Home Sleep Study - Summary & Interpretation
Patient:
Demo Demo
123 Street
Decatur, AL 35603
Male, DOB: 12/25/1955 BMI 38.5
Ordering Physician:
Preferred Medical Equipment Supplier:
N/A
Demo Demo
Fax: 555-555-5555
NPI: 1234567890
IDS Test # 857191 Quick Summary: Patient self-administered a Home Sleep Study with Resmed Apnealink Plus Type 3 device while on Room Air on
2010-03-07. An AHI of 20 was scored during evaluation period of 06:51:39. Medicare guidelines (NCD 240.4) state that AHI of 20 will meet coverage
criteria for Positive Airway Pressure in combination with treating physician's clinical correlation.
Sleep Specialist Interpretation of Home Sleep Study
Impressions:
TE
ST
• The diagnosis of at least moderate sleep apnea is supported based on the reported Apnea-Hypopnea Index (AHI*)
• Oxygen saturation was < 90% for more than 5 minutes, minimum oxygen saturation was below 90, and mean oxygen
saturation was below listed norms, which suggests hypoxemia.
• Sleep apnea may have contributed to the oximetry findings. In addition, oxygen saturation can be affected by numerous
conditions including, but not limited to restrictive or obstructive pulmonary disease, neuromuscular disorders, and recorded
artifact.
E
Recommendations:
PL
• Consider Sleep Apnea treatment as appropriate for this patient.
M
• Treatment options may include: Positive Airway Pressure (PAP) devices such as continuous PAP (CPAP), auto-adjusting PAP (APAP), and
bi-level PAP (Bi-PAP). Oral appliance implementation during sleep and upper airway surgery may be considered in selected patients as
deemed suitable by the appropriate specialist.
• If APAP is utilized for titration and/or treatment, an initial range setting of 5-20 cm H2O may be considered if there are no contraindications.
SA
• If CPAP is utilized without APAP titration an in-laboratory facility based titration is recommended.
• With any PAP device, monitor patient compliance via downloadable reports if available. *Medicare has specific compliance requirements
during the first 90 days of use. See pg 4 for details
• Weight loss and smoking cessation are behavioral interventions which may supplement a primary treatment for sleep apnea. Improvement
in sleep apnea may be assessed following successful completion of the aforementioned.
• Alcohol and sedative use may worsen sleep apnea and daytime sleepiness. Patient counseling is recommended as appropriate.
• Where applicable, utilize PAP device efficacy reports, additional testing, and face to face clinical evaluation subsequent to any treatment,
changes in treatment, or major behavioral modifications.
• If symptom resolution is not achieved, or suspicion of continued sleep disturbance persists, consider referral to a sleep specialist.
• As long as patient exhibits symptoms of daytime sleepiness or drowsiness, caution against operating a motor vehicle, or engaging in other
activities which may be hazardous in the presence of diminished alertness
• Recommend further evaluation of suggested hypoxemia via nocturnal pulse-oximetry.
• If indicated, supplemental oxygen may be considered in conjunction with selected Apnea treatment. (Refer to an appropriate specialist as
needed.)
Signed on 3/12/2010 4:33:00 PM by Dr. EDWARD TURPIN, ABSM; NPI: 1225118847
NOTE: Please see page 4 for important footnotes, clinical reference, and more detail about home sleep studies and the Apnealink device and software.
Instant Diagnostic Systems, Inc.
Independent Diagnostic Testing Facility - NPI: 1922017516
1740 4th Ave. SE, Suite A, Decatur, AL 35601
Mailing Addr: PO Box 2449, Decatur, AL 35602
Phone: 800-355-0691 Fax: 888-771-5159
Page 2 of 4
Home Sleep Study - Analysis
Patient:
IDS Report #: 857191
Evaluation Start/Stop Time: 22:10
ST
Apnealink+ Mfg by Resmed Germany; Records Airflow, Respiratory Effort, Pulse Rate, O2 Saturation:
Recording Started:
- 5:1
Total Valid Evaluation Time*: 06:51:39
Analysis:
Serial #: 223190000485
2010-03-07 at 22:00:00
Recording Duration: 07:03:40
Spo2* 06:53:09 )
TE
Analyzed Automatically (Total Eval Times - Air-Flow* 06:51:39
* Total Airflow Eval Time is the denominator used in calculation of AHI and other event indices above, while Spo2 Eval Time is used for Pulse-Oximetry indices below.
Indices/Averages
Normal Range
Totals:
AHI* (Apnea Hypopnea Index) 20
< 5/hr
Snoring Events
3558
All Apneas Index
< 5/hr
Total Apneas
62
- Obstructive Apneas
56
- Central Apneas
1
- Mixed Apneas
0
- Unclassified Apneas
5
Total Hypopneas
75
Breaths
4523
- Central Apnea Index
0
- Mixed Apnea Index
0
11
SA
Hypopnea Index
M
- Unclassified Apnea Index 1
Avg Breath per min.
PL
- Obstructive Apnea Index 8
E
9
< 5/hr
-
10.99
% Flow Ltd Br. w/o Snore 9
< Approx 60
Total Flow Ltd. Br w/o Snoring
422
% Flow Ltd. Br. w. Snore
< Approx 40
Total Flow Ltd Br w/ Snoring
544
12
Proportion of probable Cheyne Stokes epochs: 0% --Normal: 0%
Pulse Oximetry
O2 Desaturation Index
19
< 5/hr
Avg. Saturation
93
Lowest Desat Event
Total Desaturations
132
94% - 98%
Spo2 <= 90%
51 Min.
12%
63
-
Spo2 <= 89%
34 Min.
8%
Lowest Saturation
63
90% - 96%
Spo2 <= 88%
29 Min.
7%
Baseline Spo2
97
-
Spo2 <= 85%
22 Min.
5%
Avg Pulse Rate (bpm)
63
-
Spo2 <= 80%
12 Min.
3%
Max Pulse Rate (bpm)
101
60 - 90
Min Pulse Rate (bpm)
40
50 - 70
Invalid Spo2 During Airflow Evaluation: 0.1%
Auto Analysis Default Parameters:
Apnea [20%; 10s; 80s; 1.0s; 20%; 60%; 8%]; Hypopnea [50%; 10s; 100s; 1.0s]; Snoring [6.0%; 0.3s; 3.5s; 0.5s]; Desaturation [4.0%]; CSR [0.50]
Analyzer Ver. - 3.01
Ahts DL L - 2.3.1.0
Collector Ver. - 2.01
Lin DL L - 142
IDS Sleep Ver. - 3.09.10.26
Firmware- 05.0200000
Flt DL L- 145
Rs DL L - 113
Oxi DL L - 58
Oximetry Successful? True Device Code- 0000000C
Instant Diagnostic Systems, Inc.
Independent Diagnostic Testing Facility - NPI: 1922017516
1740 4th Ave. SE, Suite A, Decatur, AL 35601
Mailing Addr: PO Box 2449, Decatur, AL 35602
Phone: 800-355-0691 Fax: 888-771-5159
Patient:
SA
M
PL
E
TE
ST
IDS Report #:
Page 3 of 4
857191