sleep studies

  1. M

    Wiki 95811

    Normally we would bill a 95811 with a 52 modifier if there was less than 6 hours of recording. However, I have a new occurrence were we had zero sleep time recorded and the test was stopped at 78 minutes. Can we still bill for tech time an reduced services?
  2. J

    Wiki Sleep Center Conversion from HOPD to Ambulatory Practice

    My company will be transitioning a sleep center that's currently owned by a hospital to an ambulatory (office) practice. Is there anything billing related that we should be aware of in this transition? I was looking for guidance on global vs split 26/TC billing for the technologist supervised...
  3. C

    Wiki sleep studies

    Does anyone have any good references or know of anything that would help to ensure I am billing sleep studies correctly? In addition to the general coding, perhaps the dates of service to be used, the place of service, etc? One of the main questions we have is if the technical component is...
  4. N

    Wiki Technical Component for Sleep Studies

    HELP! I'm a newer billing and still learning so much. The sleep center that my doctor always used just closed and he is wanting to start his own. He is looking into getting a HST machine and hiring a sleep tech to manage it right from our office. My question is being a physician office and...
  5. N

    Wiki Sleep Study Question

    I have started coding sleep studies for a new client for my employer. They are billing the global fee for the sleep studies (they own the equipment and their physicians do the interps) They have instructed me that with the sleep studies, the date of service should be the date the study started...
  6. D

    Wiki 94660 Requirements

    Hi - I am hoping someone will be able to offer some guidance. Our group has a neurologist who is interested in performing CPT 94660 - The practice has hired a technician and the question has arisen as to who can actually bill for this procedure code. I have found the following: "CPT code...
  7. L

    Wiki Palmetto GBA- NC area- MSLT LCD L36593 Coding

    Palmetto GBA recently updated their allowed DX codes for sleep studies. The most effected one for us was for the MSLT 95805 codes. It was once allowed to use Hypersomnia as an allowed and now they no longer seem to be allowing symptoms as their only options are diagnosis. But the point of the...
  8. L

    Wiki Palmetto GBA- NC area- MSLT LCD L36593 Payments

    Palmetto GBA recently updated their allowed DX codes for sleep studies. The most effected one for us was for the MSLT 95805 codes. It was once allowed to use Hypersomnia as an allowed and now they no longer seem to be allowing symptoms as their only options are diagnosis. But the point of the...
  9. L

    Wiki Palmetto GBA- NC area Sleep Studies & Modifier 52

    Can anyone assist me? I have been having difficulty getting MCR to pay for sleep studies 95810, 95811 if less than 6 hours. According to their LCD it states 6 hours of recording with no mention about what to do for less than 6 hours. But according to CPT AMA if less than 6 hours you need to...
    • Launie75
    • Thread
    • medicare mod 52 modifier 52 palmetto gba sleep studies
    • Replies: 4
    • Forum: Modifiers
  10. B

    Wiki Sleep Studies

    I work for a Sleep Disorder Center and we perform the studies and read them all in the same office by the same doctors. I'm billing 95810 and 95811. We get paid okay by all payors except for Colorado Medicaid and because of this I'm being questioned on how I'm coding. The people in my office who...
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