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Pulmonology Coding Alert

Reader Questions:

Support Your PSG Repeat Test With Documentation

Published on Sat Nov 20, 2010

Question: How often can I bill for polysomnography (95811) when the initial testing is inconclusive? One of our patients has inconclusive test results twice? Answer: A "split-night" study (initial diagnostic PSG followed by CPAP Titration during PSG on the same night) may be an alternative to one full night of diagnostic PSG followed by a second night of Titration as long as: CPAP Titration is carried out for more than 3 hrs, and PSG documents that CPAP significantly improves patient respiration during sleep. The use of CPAP devices is covered under Medicare when ordered and prescribed by the licensed treating physician to be used in adult patients with OSA if either of the criteria noted above are met. If you are stating that the results of the initial testing were inconclusive that the patient has OSA, CPAP initiation would not be indicated, and you should only perform and report 95810 [...]
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