Neurology & Pain Management Coding Alert

Reader Question :

Stay Alert on Polysomnography Coding

Question: We recently opened a sleep lab, and performed an overnight sleep staging study for a patient with parasomnia due to suspected nocturnal seizures. We set up the patient in our lab while a technician monitored the progress. We billed for 95806, but the claim was rejected. What went wrong? Oklahoma Subscriber Answer: Answer: You may have gotten a denial because you performed polysomnography, not a sleep study. You should instead choose from three polysomnography codes, depending on the number of additional parameters of sleep that were tested: 95808 -- Polysomnography; sleep staging with 1-3 additional parameters of sleep, attended by a technologist 95810 -- ... sleep staging with 4 or more additional parameters of sleep, attended by a technologist 95811 -- ... sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist. What's the difference? One difference [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.