Medicare WISeR service

Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea

CPT 64582 is in scope. HCPCS C8007 and C8011 are subject to WISeR for dates of service on or after April 6, 2026.

Documentation overview

Documentation categories to review

These categories summarize the approved criteria bundle. The note checker uses the selected state, clinical pathway and procedure details to apply the relevant criteria.

Core documentation

  • Age 22 or older
  • Body mass index below 35 kg/m²
  • Qualifying polysomnography within 24 months
  • CPAP failure or intolerance
  • Drug-induced sleep endoscopy showing no complete concentric collapse at the soft palate
  • Anatomical assessment
  • MRI counseling
  • Absence of listed contraindications

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Educational use only

This page summarizes public CMS documentation criteria. It does not provide medical, legal or coding advice, determine Medicare coverage, predict prior-authorization outcomes, or replace clinical judgment. Coverage decisions are made by CMS and its contractors. Verify the effective policy for the patient’s date and place of service before relying on this summary.