CPT^® 95811, Under Sleep Medicine Testing Procedures

The Current Procedural Terminology (CPT^®) code 95811 as maintained by American Medical Association, is a medical procedural code under the range - Sleep Medicine Testing Procedures.

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Summary

During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.

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Is DOS the Date of interpretation for 95811

HI For PSG test 95811, we bill the professional component only with 26 modifier. Should we use the date of interpretation by the MD as the DOS on the claim? Per CPT assistant 2002, it looks like th... [ Read More ]

95811 95811 modifiers sleep modifiers sleep studies sleep study coding

Normally we would bill a 95811 with a 52 modifier if there was less than 6 hours of recording. However, I have a new occurrence were we had zero sleep time recorded and the test was stopped at 78 min... [ Read More ]

sleep study is done first and then evaluation

Hello, I do the coding for sleep medicine and often the clinic does the sleep study first 95811 and then a couple days later does the evaluation 99204. But then the 99204 is denied by the insurance as... [ Read More ]

VNS coding for 2019

Does any one have any idea on the 95977? We have a provider billing a sleep study 95811 w/ 95977 but we are not sure what dx to use with the 95977, we use G47.33 for severe sleep apnea. Thank you... [ Read More ]

Sleep Medicine Reimbursement

I am trying to get information on reimbursement on CPT codes 95810 – Adult in lab test 95811 – Adult in lab test 95806- Home sleep test As related to the changes that the American Academy of S... [ Read More ]

Sleep Medicine Reimbursement

Sleep Medicine 95810 or 95811 going into MSLT 95805 polysomnogram

Here's the situation: The patient is already using a prescribed CPAP device and is having an overnight polysomnography before a Multiple Sleep Latency test (95805). This patient completes PSG in our... [ Read More ]

what place of service code to use for in-house credentialed sleep lab?

Te practice has a credentialed sleep lab in office, and they are performing monitored polysomnography. They are getting many denials for POS when 95810 & 95811 are submitted with POS 11. The lab is ... [ Read More ]

High Flow in Pediatrics

Can a pediatric sleep study that requires a high flow titration be billed as a titration study using 95811/95783?... [ Read More ]

Home Sleep Study article from March 2018 Healthcare monthly magazine

Hi- If there are any pulmonary/sleep coders out there I have a question regarding the recent article about sleep studies done at home. The article lists temporary G-codes that are billable to Medicar... [ Read More ]

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