Question:
How do you bill for a split-night sleep study?
Answer:
For a split study, it is appropriate to report only the most extensive procedure code. For example, a PSG being performed on a patient over the age of six is initially identified by CPT® code 95810. If during the study it becomes necessary to apply CPAP to relieve episodes of apnea, at the point, the mask is applied CPT code 95811 now defines the procedure. It would be inappropriate to report both code 95810 and 95811, only 95811 would be billed because it is the more extensive procedure. The application of the CPAP should not be reported separately.
This question was answered in our Coding Essentials for RT/Pulmonary Function. For more hot topics relating to respiratory services, please visit our store or call us at 1.800.252.1578, ext. 2.
CPT® copyright 2024 American Medical Association (AMA). All rights reserved.
Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
CPT is a registered trademark of the American Medical Association.
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