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Sleep Study

  1. #1
    Default Sleep Study
    Medical Coding Books
    I have a provider who is billing 95810 with POS 12 (Home).Medicare is denying for invalid POS. The sleep study is being done unattended. I gave the provider three unattended descritption Sleep study unattended simultaneous recording of heart rate, oxygen saturation, respiratory airflow and respiratory effort(eg, Thoracoabdominal movement)Sleep study unattendedthat measures heart rate, oxygen saturation, respiratory analysis and sleep time. Sleep study minimal that measures heart rate, oxygen saturationand respiratory. He does the interpretation of the study. He states he is doing the second description which in the CPT book the code is 0203T. Doesn't that mean he will not be reimbursed for his interpretation of the study or is there anothre CPT code. Sorry this was so long and once again Thanks for your help.

  2. #2
    Default Sleep Study
    For a home sleep study that is unattended - we bill code 95806 - and receive payment from Medicare.

    Lori

  3. #3
    Default Sleep Study
    Thank You Lori for your reply, but I have another question. Medicare has also created HCPCS codes for Home sleep studies unattended & temporary codes, so with that being said which would be correct?

  4. #4
    Location
    Maryville
    Posts
    17
    Default Home Sleep
    Since the physician is doing the intrp only you would bill 95806-26 with place of service of for outpatient since the provider is not doing the interp in his home.

  5. #5
    Default
    We are about to bill our first home sleep study interp. What do you all use for the facility? Would it be appropriate to use the sleep lab for the facility? I would think the example claim would be 95806-26, pos 11, with the facility being the Sleep Lab name??

  6. Default Sleep study DOS or Date of Interp./Report
    Quote Originally Posted by 13kpcpc View Post
    Since the physician is doing the intrp only you would bill 95806-26 with place of service of for outpatient since the provider is not doing the interp in his home.
    For Sleep Studies 95805,26 95806,26 95810,26 95811,26 do you bill with DOS or Date of interpretation/report?

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