Neurology & Pain Management Coding Alert

Prepare for Sleep Test Audit by Focusing on Work-Up Notes

These clues help you distinguish between 95805-95807 and 95808-95811.

Dont be surprised if the OIG wants to check out your sleep study and polysomnography medical records to confirm that patients pretest signs, symptoms, or conditions in your physicians documentation justify the study.

Between 2001 and 2005, Medicare payments for polysomnography payments (95808-95811) increased sizably, by $153 million, triggering the Office of the Inspector General (OIG) to take a good long look atthese tests in 2009. Because sleep studies (95805-95807) are commonly confused with polysomnography, the OIG will also be looking at these codes.

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