Pulmonology Coding Alert

Question: We recently started performing actigraphy - what is this, and can we report this service with other sleep studies?

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Answer: Actigraphy is a non-invasive recording of gross motor movements that helps your pulmonologist assess the patient's rest/activity cycles across many days. Actigraphy is useful in evaluating insomnia, circadian rhythm sleep disorders, excessive sleepiness and restless leg syndrome. Typically, the minimum actigraphy recording should last three days and for a maximum of fourteen days.

You report actigraphy with 95803 (Actigraphy testing, recording, analysis, interpretation, and report [minimum of 72 hours to 14 consecutive days of recording]). You should not report 95803 more than once for a 14-day period.

If your pulmonologist is also conducting other sleep study procedures, you should be aware of Correct Coding Initiative (CCI) edits that are in place that bundle 95803 with other sleep study codes. For instance, if your pulmonologist is also testing maintenance of wakefulness (95805, Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness), you cannot also report 95803, as CCI edits bundle these two procedures together with the modifier indicator '0,' which means that these codes cannot be reported together under any circumstances.