Be Sure to Choose a Payable Diagnoses for 95805-95811
Published on Tue Jul 01, 2003
Acceptable diagnoses for sleep studies and polysomnography (95805-95811 and 54250) differ from payer to payer, although Medicare guidelines set the standard. Below is a partial list of acceptable diagnoses derived from the local medical review policies of several Medicare carriers throughout the nation. Contact your individual payers for a complete list of applicable ICD-9 codes (Note: Code 95806 [unattended study] is not covered). For 54250:
302.72 Psychosexual dysfunction; with inhibited exual excitement
607.84 Other specified disorders of penis; impotence of organic origin. For 95805:
347 Cataplexy and narcolepsy
780.53 Hypersomnia with sleep apnea
780.54 Other hypersomnia. For 95807-95811:
278.01 Morbid obesity with sleep apnea
278.8 Pickwickian syndrome
333.2 Myoclonus
345.8x Nocturnal seizures
347 Cataplexy and narcolepsy
518.81 Acute respiratory failure
780.09 Alteration of consciousness; drowsiness, somnolence
780.51 Insomnia with sleep apnea
780.53 Hypersomnia with sleep apnea
780.54 Other hypersomnia
780.55 Disruptions of 24-hour sleep-wake cycle
780.56 Dysfunctions associated with sleep stages or arousal from sleep
780.57 Other and unspecified sleep apnea
780.59 Other sleep disturbances.
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