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Sleep study

  1. #1
    El Paso Texas
    Default Sleep study
    Medical Coding Books
    I have annual sleep studies. When I go to the drs office the next week, he discusses the results of the sleep study, and makes any adjustments to the CPAP. I notice he bills the insurance company low or moderate level E&M. CPT states "the sleep services (95805-95811) include recording, interpretation, and report." Sharing his interpretation of the study with me does not constitute an E&M visit. Am I right or wrong?
    Donna Sorenson CPC, CMRS, RHIT
    AAPC Local Chapter El Paso Texas

  2. #2
    Stratford, NJ
    If on your return visit, the doctor performs, and documents, the necessary history, exam, MDM for an E/M code, then yes, he should bill it, along w/any procedures performed such as the adjustment. I have no background in sleep studies, so I'm not sure what's billable and what's considered bundled. But as in any office visit, the same rings true...In order to bill an E/M code for a return visit, he must have documented all necessary functions of that code.

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