Hypoglossal Nerve Stimulator: A Novel Treatment Approach for Obstructive Sleep Apnea Overview of Treatment, Including Diagnostic and Patient Criteria, Procedural Terminology Codes.

Unilateral stimulation of the hypoglossal nerve may result in clinically valuable patency of the upper airway in well selected patients for treatment of obstructive sleep apnea. The Food and Drug Administration has established stringent criteria for the placement of this medical device. The treatment is a consideration among patients who have been non adherent or intolerant of PAP therapy, with moderate to severe OSA and a Body Mass Index of \u003c 32 kg/m2. Some of the insurance providers have lowered BMI guidelines to allow implantation in patients with a BMI \u003c 35 kg/m2. Further, there is a clinical assessment with sleep endoscopy to define proper anatomy and to determine, based on the results, if the patients are appropriate surgical candidates. Current Procedural Terminology codes that are specific to the placement as well as removal, and or replacement of the device are discussed as well as the sleep medicine related evaluation and management.