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Pulmonology Coding Alert

Claim Your Share of the Sleep Study Pie With This CMS Policy Rundown

Published on Tue Apr 28, 2009

Medicare promises to cover facility and home-based testing -- as long as you meet these criteria. Thanks to the green light CMS gave sleep testing in March, you may have an easier time receiving reimbursement for sleep studies provided that you meet certain guidelines for the types of patients you test and the equipment you use -- heres the skinny: New: CMS announced March 3 that it will cover specified sleep tests that pulmonologists use to confirm the diagnosis in patients who have clinical signs and symptoms of obstructive sleep apnea (327.23). The agency will cover tests your pulmonologist conducts in a sleep laboratory facility in addition to many types of home sleep testing. You can expect other payers to follow Medicares lead; Aetna, for example,recently released a similar sleep study policy found here: www.aetna.com/cpb/medical/data/1_99/0004.html. Important: The policy does not apply to the use of sleep testing for other purposes beyond [...]
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