Respiratory Compliance Question of the Week
August 4, 2008
Question:
My question relates to sleep studies and CPT code 95807. Does the following statement from the CPT book apply to sleep studies and polysomnography or just to the statement above it for polysomnography? (Report with modifier 52 if less than 6 hours of recording or in other cases of reduced services as appropriate.)
Answer:
The first sentence of the coding guideline for this group of CPT (95805-95811) states: "Sleep studies and polysomnography refer to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for 6 or more hours with physician review, interpretation and report."
When, for whatever reason and despite the best efforts of the therapist,
the patient is unable to achieve six or more hours of documented sleep,
the applicable CPT code is to be reported with modifier 52 appended to communicate
to the payer that the full definition of the service was not meet.
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