Pulmonology Coding Alert

Question: I have a report where the pulmonologist used actigraphy to evaluate a patient with COPD for difficulty sleeping. The report states the actigraphy lasted for five days.

What code should I use to report the service?

Louisiana Subscriber

Answer: You’ll assign 95803 (Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)) to report the actigraphy service. Code 95803 requires a minimum of three days of monitoring and covers up to a maximum of 14 days. You indicated the provider monitored the patient for five days, which makes 95803 the correct code choice.

Actigraphy is a noninvasive service where a portable device records the patient’s gross motor movements while they sleep. The provider reviews the data to assess the patient’s rest and activity cycles over several days. A provider orders actigraphy to diagnose several possible sleep difficulties, such as insomnia, excessive sleepiness, restless leg syndrome, and circadian rhythm sleep disorders.

Know the limits: CPT^® guidelines instruct that you should not report 95803 more than once in a 14-day period. The guidelines also direct you to not report 95803 with sleep study or polysomnography codes.