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Sleep Studies

Melissa Posted Mon 07th of July, 2014 10:16:20 AM

I am new to sleep studies and want to make sure I am doing this correctly. I am coding for a Physician who is interpreting sleep studies. The physician is employed by a hospital that owns the practice. For home sleep study interpretation, is it appropriate to code 95801-26 and the G0399 code?

SuperCoder Answered Tue 08th of July, 2014 09:13:10 AM

Thanks for your question.

You may use any one code from the codes 95806, 95800 and 95801 appended with modifier 26 for the physician’s work of interpreting the test. Choice of code depends upon the different component, the provider is studying like heart rate, respiratory study etc.

Also use the G code from the range G0398 and G0399 for the work of instructing the patient in the use of the equipment. Choice of code depends upon number of channels used and component studied.

Thanks !!

Melissa Posted Wed 09th of July, 2014 14:39:54 PM

If a technician in the office provides the instructions on the equipment, can I still bill the G Code? Also, can I bill these codes on the same claim form or do they have to have different dates?

SuperCoder Answered Thu 10th of July, 2014 07:56:15 AM

Yes, you may still bill. Just that, proper documentation should be maintained regarding the diagnosis, requirement of the test and service provided. And, it should be reviewed and signed by physician.

Thanks !!

Melissa Posted Mon 14th of July, 2014 12:05:01 PM

Do I need to put the G-code and the Interpretation code on separate dates of service? separate claims

SuperCoder Answered Tue 15th of July, 2014 02:51:16 AM

The date that the sleep study device is actually applied is the date that must be billed with the appropriate G code. Likewise the date that the sleep study is actually interpreted is the date that must be billed with 95806-26. Also, place of service is an important consideration. Use POS-12 (Home) with G code and POS-11 (Office) with 95806 for physician interpretation at his office.

Thanks !!

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