Wiki 95803 Actigraphy reimbursement

[hsmith67]

I have a billing client that is a sleep specialist that has purchased several actigraphy devices to be worn by patients. The CPT code is 95803. I have not been successful in getting any payer, commercial or CMS, to pay for the testing - even though the testing is done on dates of service other than office visit (so not "incidental" to E&M). Can anyone definitively settle this dispute between me and my client who says "the code wouldn't exist if nobody pays for it" as I can't solve this riddle of getting it paid. The vendor is not responding to calls, which in and of itself tells me quite a bit.

Thanks for any help!
Hunter Smith, CPC

 

[bmjohnson73]

A provider in our organization is wanting to pursue Actigraphy. I was wondering if you ever had any luck getting paid for this service. I have found that several companies still deem this service as experimental. Also, could you please share the documentation guidelines for Actigraphy. Many thanks!