Wiki Billing professional component of sleep study

[tba123]

My provider sends patients to the local hospital for sleep studies, however he reads the study, so we bill 95810-26. My question is what facility should I bill with? I would not think I would use the hospital, even though that is where the test was done, I would assume I would use our office since that is where he read, interpreted the study.

Ideas?

Anna Sanders

 

[kristinowens]

sleep study POS

My provider also reads sleep studies done at hospital, and where the service is provided is where POS is or #22 outpatient.

 

[tba123]

So even though he is not a hospital employee, and he is reading the report in his office, I would still bill POS as 22 and use the hospital as facility on the -26 claim?

 

[mhstrauss]

So even though he is not a hospital employee, and he is reading the report in his office, I would still bill POS as 22 and use the hospital as facility on the -26 claim?

Yes, this is correct, per guidance from CMS; see "F" here:

https://www.cms.gov/medicare/medica...ianfeesched/downloads/faqs-cr7631-4-25-13.pdf

 

[tba123]

Thank you!!