Wiki Actigraphy Testing

[shorn@wellspan.org]

Does anyone bill for CPT 95803 (actigraphy testing) and what reimbursement are you or are you not receiving. Our reimbursement specialists are telling us this CPT code is experimental and insurances will not pay. If you are doing actigraphy testing and do not use CPT 95803, what code are you using for reimbursement. Thank you.

 

[rhondareeney]

We do Actigraphy here and have had zero luck with any form of payment. Always deemed experimental.

 

[MarcusM]

http://www.cms.gov/apps/physician-f...h-results.aspx?Y=0&T=0&HT=0&CT=3&H1=95803&M=5
Has reimbursements for CPT 95803,

AAPC Coder Tool lists: 95803
Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
Notes:
(Do not report 95803 more than once in any 14 day period)

(Do not report 95803 in conjunction with 95806-95811)

Tip: Experts agree that further studies should be conducted to determine the safety and effectiveness of actigraphy for the diagnosis and treatment of obstructive sleep apnea (780.57). Nevertheless, feel free to report 95803 (Actigraphy testing, recording, analysis, interpretation, and report [minimum of 72 hours to 14 consecutive days of recording]), as long as you can prove medical necessity.
Here are a few facts about actigraphy coding that should serve as your guidelines.
The actigraphy code is labeled "carrier priced" by CPT, which means that it's up to the Medicare carrier to decide how much to pay.
Remember, too, that 95803 has both a professional and technical component. Submitting both facility and professional claims for actigraph testing will pose no problem.

 

[bmjohnson73]

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