MSLT sleep test

barrski

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I am hoping someone can help me with this. If a patient is having a MSLT test to check for narcolepsy but the results come back negative, what diagnosis code do you use? I've found information in the LCD that states 'diagnostic testing is covered when the patient has the symptoms of narcolepsy and the diagnosis is usually confirmed with the test.' But what if the diagnosis is not confirmed?? Thank you for any help.:confused:
 

alincoln

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I am hoping someone can help me with this. If a patient is having a MSLT test to check for narcolepsy but the results come back negative, what diagnosis code do you use? I've found information in the LCD that states 'diagnostic testing is covered when the patient has the symptoms of narcolepsy and the diagnosis is usually confirmed with the test.' But what if the diagnosis is not confirmed?? Thank you for any help.:confused:

You should report the symptoms that prompted the provider to order the test if the test came back negative for narcolepsy. What was documented in the office visit relating to the order of the test or more importantly on the order for the test?
For example - daytime sleepiness, hallucinations, sleep paralysis etc...
 

barrski

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The patient complains of fatigue, daytime hypersomnolence and sometimes has difficulty initiating sleep. The patient also has racing thoughts with depression which is currently being treated. The doctor selected sleep disordered breathing 327.23 as the diagnosis suspected. The sleep center put rule out OSA -obstructive sleep apnea. I have come up with 780.53, 780.79 as the symptoms. However, due to the patients history of depression (since childhood) would 307.43 be more suitable?
 

alincoln

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I would change 780.53 to 780.54 - because when the test was ordered, it was unknown whether the pt had apnea with their hypersomnia. I agree with the 780.79 as well.
I would be leery of assigning 307.43 until it the patient was actually diagnosed with insomnia (which the study didn't support in the end). You might be able to use 307.49 as subjective report of insomnia.. but I would probably just use the first two symptoms 780.54 hypersomnia and 780.79 fatigue.
 
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