Neurology & Pain Management Coding Alert

Answer: A split-night service is a sleep study that combines a 2 – 4 hour diagnostic test and a therapeutic test in the same night.  Patients that are diagnosed with severe obstructive sleep apnea (OSA) diagnosis may benefit from a split-night sleep study as it allows for immediate treatment. 

 

For example, if a provider begins a diagnostic polysomnogram at 9 p.m. and can make a diagnosis of OSA early on, the provider may then begin the continuous positive airway pressure (CPAP) therapy titration at midnight or later and complete a split-night service. In this scenario, a provider should submit a single split-night claim. Although the entire care includes both a diagnostic study on the date the procedure began and a CPAP titration service on the date service ended, you still report only one code. 

 

CPT® does not include a separate code for a split-night study. You should report 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 ) for a split-night sleep study. It would not be appropriate to bill the diagnostic portion and therapeutic titration portion of a study separately.  Doing so would be billing for two studies, when only one was performed.