Reader Questions:
Switch to Medicare's Codes for Sleep Studies
Published on Tue Nov 03, 2009
Question: Our neurology practice is considering providing home sleeps studies. Does Medicare cover sleep studies when performed in the patient's home? California Subscriber Answer: As is often the case, the answer is "it depends." In March 2008, Medicare expanded its national coverage determination (NCD) for sleep studies to include restricted coverage of home sleep tests, a.k.a. portable monitoring, only for the detection of obstructive sleep apnea (OSA). The NCD confirmed coverage not only for in-lab, attended polysomnography but also for unattended sleep testing performed in or out of a sleep facility using any Type II, Type III, or Type IV monitoring devices. Sleep testing monitoring devices are classified into the following types: • Type I monitoring: Full in-laboratory polysomnography • Type II monitoring: Comprehensive portable polysomnography with a minimum of seven channels including EEG, EOG, chin EMG, ECG or heart rate, airflow, respiratory effort, and oxygen saturation • Type III [...]
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