Neurology & Pain Management Coding Alert

Overusing Dx codes is just one way to attract an audit. The Office of the Inspector General (OIG) has had polysomnography sleep codes (95808-95811) on its watch list for a few years now. The popular sleep lab exam is also on the OIG's 2010 Workplan. "Medicare reimbursement for polysomnography tests increased from $62 million in 2001 to $215 million in 2005," the OIG Workplan states. Why it matters: The OIG wants to make sure practices are performing polysomnography properly, and for the right reasons. So if your neurologist interprets polysomnography tests or your sleep lab performs them, you'll want to pay attention now or risk a possible audit later. OIG is Looking Hard at Apnea Diagnoses The biggest reason the OIG is looking at polysomnography is that coders often misuse the diagnosis codes submitted to justify the test. The scrutiny isn't unexpected, says Jill M. Young,CPC-ED, CPC-IM, president of Young Medical [...]