Otolaryngology Coding Alert

Code 327.23 testing could be more easily attainable and less expensive

CMS wants your help in revising its policy on the diagnosis of patients with OSA requiring CPAP.

-Current national coverage policy specifies that only polysomnography done in a facility-based sleep study laboratory can be used to identify patients with OSA requiring CPAP,- states the CMS in its NCA Tracking Sheet for Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea (OSA) (CAG-00093R2). The American Academy of Otolaryngology-Head and Neck Surgery wants CMS to allow an at-home option. Patients who require OSA evaluation could undergo the study in the comfort of their own bed using a portable multi-channel home sleep testing device, instead of having to go to a facility-based sleep study laboratory for polysomnography.

In-lab polysomnography is an expensive test that is not widely available, writes the AAO-HNS Board of Directors in its CMS request. Home sleep testing provides patients with better access and less cost and -is a validated alternative and an important step in improving recognition and control of OSA- (327.23, Obstructive sleep apnea [adult] [pediatric]).

Act now: You have until April 13, 2007, to make your voice heard. Enter your comment after reviewing the national coverage analysis tracking sheet at www.cms.hhs.gov/mcd/viewtrackingsheet.asp?id=204.