Neurology & Pain Management Coding Alert

Question: To bill for a complete sleep study, does a technician have to provide constant attendance?

Michigan Subscriber

Answer: Medicare and most third-party payers will only reimburse for sleep studies with constant attendance, 95807 (sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist). Payment is usually denied for 95806 (sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, unattended by a technologist) because HCFA believes unattended sleep studies are generally performed outside of sleep-disorder clinics or hospital-affiliated facilities and, as such, are not medically necessary. Also, most neurologists want information about the patients sleep position that cannot be obtained unless a technologist is present during the entire study.