Wiki Home Sleep Study-a bit of conflicting

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tba123

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I have seen a bit of conflicting info regarding how to bill home sleep studies. My physician bills globally for this service, meaning we give the device to the patient/hook up, etc., and read the study. We are billing G0399 POS 12, however I seen quite a few places that we should bill G0399 on the date the patient is hooked up -THEN- bill 95806-26 POS 11 for the date the provider reads the study. Is this correct? I had assumed billing G0399 with no mods would signify to the carrier that we are global billing.

Please help!

Thanks,
Anna Sanders
 
The Manual says that the code encompasses the whole service, ie the Recording, reading and report. I would think separating them would be double billing. I found that in both the 2022 and 2023 AAPC CPT manuals on page 795 of the 2022 version and 799 of the 2023 version in the beginning of the section. I want to say is was the second paragraph.
 
Hi Tba 123,🛏️
I use to do sleep medicine billing..yes bill date provider read & interpretated the results, then actual day of sleep med test done on patient. You have correct understanding. If pt sleep less than 6 hours bill CPT 95801-95811 add modifier 52 and if pt sleep more than 6 just bill CPT code. Also sleep studies have CPT codes for children but mostly study adults. These services are bundled in sleep studies
  • ECG, EOG, EMG
  • Airflow
  • Ventilation and respiratory effort
  • Gas exchange by oximetry, transcutaneous monitoring or end tidal gas analysis
  • Extremity muscle activity and motor activity movement
  • Extended EEG monitoring
  • Penile tumescence
  • Gastroesophageal reflux
  • Continuous blood pressure monitoring
  • Snoring
  • Body positions
Well hope helped you :)🛏️
Lady T
 
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