Question:

For continuous positive airway pressure (CPAP) to be covered, does Medicare require a sleep study to diagnose obstructive sleep apnea (OSA) during the COVID-19 PHE?

Answer:

When OSA is suspected in a Medicare beneficiary and treatment is contemplated, a comprehensive sleep evaluation is important, but not required during the PHE. Along with the clinical evaluation, sleep studies can be used to help diagnose this condition. However, home sleep testing (codes G0398–G0400)
may be an appropriate replacement for institutional testing in certain patients.

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.

Facebook
Twitter
LinkedIn
Email
Print

CPT® copyright 2021 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.