# Coding an incomplete cpap titration 95811



## SantaRosa27 (Oct 18, 2010)

Does anyone know how to code a cpap titration (95811) when the patient was unable to sleep? The test continued for over 6 hours. Medicare requires that the patient sleep at least 2 hours. The patient wants to return and try again. 

My thoughts are either a modifier 52 for reduced services or tc for tech time. 

Thanks.


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## lapcpc (Oct 18, 2010)

I would append a modifier 52 to the claim (are you billing for both the report and tech time? - if so put a modifier 52 on the claim.


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## SantaRosa27 (Oct 18, 2010)

*Two modifiers?*

Since the test did not complete, there will be no report. The test will be redone. In addition to modifier 52, maybe I should also code with modifier TC for the tech time?


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## Cloudjourney (Oct 25, 2010)

I'm not sure what Medicare carrier you deal with, but Highmark will usually request records on a sleep study w/ a 52 modifier.  Our experience has been that if there isn't enough data to produce a report they won't pay, even a reduced amount.  A TC would probably be your best bet, but if you want to utilize the 52 or 52:TC you are probably going to have to file an appeal.

Good Luck!


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## nicole@ra-stx.com (Jan 7, 2011)

*HELP PLS. sleep studies*

We want to have a sleep study clinic here in our office/I know nothing regarding sleep studies. My physician asked me "how much does MC reimburse for a CPAP machine?" I have no clue, I dont even know where to start. Do we buy our own to do the testing and bill for the testing? Not the actual machine? I need HELP


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## neecie1227@yahoo.com (Jan 7, 2011)

*HELP PLS. sleep studies*

email me at my login name but please titile it accordingly so I can recognize it


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