Otolaryngology Coding Alert

Question: My otolaryngology practice deals with sleep studies, and I was wondering what new codes and what new edits we should know about?

Iowa Subscriber

Answer: CPT^® 2013 brought you expanded coding options for reporting polysomnography depending on age. You now have two new codes to report when your otolaryngologist performs these services to a child aged below six:

·         95782 (Polysomnography, younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist)

·         95783 (Polysomnography, younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist)

You can count the following codes as mutually exclusive to both of these new procedures:

·         95800 — Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time

·         95801 — … minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone)

·         95808 — Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist

·         95810 (with 95783) — … age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist

·         925811 (with 95782) — … 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

·         G0398 — HOME SLEEP STUDY TEST (HST) WITH TYPE II PORTABLE MONITOR, UNATTENDED; MINIMUM OF 7 CHANNELS: EEG, EOG, EMG, ECG/HEART RATE, AIRFLOW, RESPIRATORY EFFORT AND OXYGEN SATURATION

·         G0399 — HOME SLEEP TEST (HST) WITH TYPE III PORTABLE MONITOR, UNATTENDED; MINIMUM OF 4 CHANNELS: 2 RESPIRATORY MOVEMENT/AIRFLOW, 1 ECG/HEART RATE AND 1 OXYGEN SATURATION

·         G0400 — HOME SLEEP TEST (HST) WITH TYPE IV PORTABLE MONITOR, UNATTENDED; MINIMUM OF 3 CHANNELS

All of these edits have a modifier indicator of “0,” which means you cannot separate these edits under any circumstances.