Neurology & Pain Management Coding Alert

Question: Notes indicate that the provider performed an actigraphy, with ‘test, recording/analysis, interp/report.’ I’m new to this field and I’m at a loss. Could you explain what an actigraphy is and how I should code for it?

Montana Subscriber

Answer: First, you’ll choose 95803 (Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)) for the actigraphy. If you’re new to this code, remember never to report it more than once in a 14-day period, per CPT^®. Further, CPT^® prohibits reporting 95803 with any of the following codes:

• 95806 (Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement))
• 95807 (Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist)
• 95808 (Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist)
• 95810 (Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist)
• 95811 (Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist)

Actigraphy defined: “Actigraphy is a non-invasive technique used to assess cycles of activity and rest over several days to several weeks,” according to Stanford Health Care. The data an actigraphy produces “can be very helpful for assessing circadian rhythm disorders such as advanced or delayed sleep phase disorder and insomnia,” Stanford Health Care explains.

Providers might ask the patient to wear an actigraph for a period of time, which helps to produce an objective measurement of the patient’s sleep schedule. “An actigraph is worn like a watch on the wrist of your non-dominant hand and measures activity through light and movement,” per Stanford Health Care.