PAP-NAP Sleep Coding

[slgarland]

I work at a pulmonary practice that is looking at offering the new PAP-NAP or DAY-NAP form of sleep studies. Any information on your experiences billing and coding these tests if greatly appreciated.

 

[lnelms]

We use CPT 95807 with 52 modifier since is less than 6 hours of recording.

CPT 95807 - "Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist"

Notes: "Report with modifier -52 if less than 6 hours of recording for 95800, 95801 and 95806, 95807, 95810, 95811"

A PAP-NAP is a short daytime encounter that is designed to help the patient adjust to CPAP treatment. It will help your patients with their therapy compliance as well as assuring their full understanding of CPAP treatment and benefits.
Common indications that a PAP-NAP may be needed are if the patient:
- discontinued home therapy;
- left sleep lab prior to completing PAP study;
- refused treatment;
- experiences discomfort, or shows resistance to mask or pressure;
- exhibits claustrophobia or anxiety;
- experiences inability to fall asleep with PAP therapy.
During the PAP-NAP our qualified sleep technologist (supported by our sleep physician) has an opportunity to help identify and work through a number of barriers with the patient, such as:
- ensuring proper mask fitting;
- assisting with pressure desensitization;
- assessing and addressing weak emotional processing skills/anxiety;
- educating the patient about the importance of CPAP therapy.