Pulmonology Coding Alert

Question: My patients often receive polysomnography followed by MSLT the next day. Can we bill for both and, if so, which codes should we use?


Colorado Subscriber

Answer: You can report both tests when a patient receives polysomnography one day, and a multiple sleep latency test (MSLT) the next.

MSLT or maintenance of wakefulness test (MWT) and polysomnography measure different types of information, and the patient undergoes the tests during different times of the day. Polysomnography measures the patient's sleep during the course of the night, while MSLT or MWT measure periods of daytime sleepiness. Because they are separate diagnostic tests, you can report both when they follow one another. 

Example: You pulmonologist recommends both polysomnography and sleep study testing for a patient on consecutive days. The polysomnography begins on Monday night, ending on Tuesday morning. You should report the appropriate polysomnography code with Monday as the date of service. Based on the type of test conducted, you would use one of the following codes:

• 95808--Polysomnography; sleep staging with 1-3 additional parameters of sleep, attended by a technologist

• 95810--Polysomnography; sleep staging with 4 or more additional parameters of sleep, attended by a technologist

• 95811--Polysomnography; 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.

Then, the patient undergoes the MSLT or MWT test on Tuesday (a few hours from the conclusion of polysomnography). Report this test with Tuesday as the date of service, using 95805 (Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness).