Part B Insider (Multispecialty) Coding Alert

Published on Mon May 26, 2014 PDF

Question: I’ve been hearing the term “split-night service” lately but don’t know what it is. Can you explain it to me? 

Answer: A split-night service can sometimes apply when a patient undergoes a sleep study. Frequently performing separate diagnostic and titration services on consecutive nights is unusual, although there are situations in which it may be necessary. 

For example, if a provider begins a diagnostic polysomnogram at 9 p.m. and can make a diagnosis of sleep apnea early on, the provider may then begin the titration at midnight or later and complete a split-night service. In this scenario, a provider should submit a single split-night claim. Although the entire care includes both a full-night diagnostic service on the date the procedure began and a full-night titration service on the date service ended, you still report only one code. 

CPT® does not include a separate code for a split-night study. You should report 95811 (Polysomnography; age 6 years or older, 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) for either a split-night study or a PAP titration study. Billing the two portions separately would be the same as billing two procedures when the physician only performed one.