Pulmonology Coding Alert

Sleep studies are tests that watch what happens to a patient's body during sleep, and try to find out what causes sleep problems. Sleep studies usually are done in a sleep lab. Sleep labs are often located in hospitals. But sleep studies also can be done with portable equipment you use at home.

The most common type of sleep study is polysomnography. A basic electroencephalography (EEG) can be done in an awake or asleep state, and monitors brainwaves, says Gabriela Gregory, MD, in Las Vegas. "It can be used to monitor the different characteristic patterns in an awake or asleep state as well as any activity caused by stimulation such as a strobe light or hyperventilation. The EEG is used in conjunction with a sleep study or polysomnography to define the different sleep stages, as well as to monitor brain activity in those stages," she adds.

Codes 95808 (Polysomnography; sleep staging with 1-3 additional parameters of sleep, attended by a technologist), 95810 and 95811, usually termed "polysomnography," require sleep staging including:

• EEG (1 to 4 leads)
• Submental Electromyogram (EMG)
• Electrooculogram (EOG) to detect arousal, REM sleep

In addition to sleep staging, code 95808 records 1-3 additional parameters of sleep, code 95810 records 4 or more additional parameters of sleep, and code 95811 records 4 or more additional parameters of sleep and CPAP use. These additional sleep parameters can include:

• electrocardiogram (ECG)
• airflow
• ventilation and respiratory effort
• gas exchange by oximetry, transcutaneous monitoring, or end tidal gas analysis
• extremity muscle activity, motor activity-movement
• extended EEG monitoring
• penile tumescence
• gastroesophageal reflux
• continuous blood pressure monitoring
• snoring
• body positions.