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1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
Coverage unchanged.|
|2/15/2016||Reviewed. No changes.|
|2/1/2015||Document updated with literature review. Coverage unchanged.|
|9/1/2011||Document reviewed with literature review. Coverage unchanged, rationale and description updated.|
|2/15/2008||Revised/updated entire document|
|1/1/2006||Revised/updated entire document|
|10/24/2006||Revised/updated entire document|
|3/1/2005||CPT/HCPCS code(s) updated, medical policy unchanged|
|10/24/2003||Revised/updated entire document|
|11/1/1997||Revised/updated entire document|
|5/1/1996||Revised/updated entire document|
|
1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
No changes.|
|2/1/2015||Document updated with literature review. Coverage unchanged.|
|9/1/2011||Document reviewed with literature review. Coverage unchanged, rationale and description updated.|
|2/15/2008||Revised/updated entire document|
|1/1/2006||Revised/updated entire document|
|10/24/2006||Revised/updated entire document|
|3/1/2005||CPT/HCPCS code(s) updated, medical policy unchanged|
|10/24/2003||Revised/updated entire document|
|11/1/1997||Revised/updated entire document|
|5/1/1996||Revised/updated entire document|
|
G0121
|
SCRN COLONOSCOPY PT NOT HI RISK
|
HCPCS
|
If the patient is at an average risk for colorectal cancer, the interval is every 10 years. If the patient is at high risk for colorectal cancer, the frequency may be more often. Patients at high risk for colon cancer generally have one or more of the following characteristics –
- Close family member (sister, brother, parent, child) who has had colorectal cancer or an adenomatous polyp
- Family history of adenomatous polyposis or hereditary non-polyposis colorectal cancer
- Personal history of adenomatous polyps, colorectal cancer or inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
HCPCS Codes for Reporting Colon Cancer Screening Services
In most cases, HCPCS Level II codes are used to report colon cancer screening services for Medicare patients. - G0121 – Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk(This code is billed for patients who are receiving a routine colon cancer screening and are not at high risk for developing the condition. Medicare covers this service once every 10 years.
|
G0121
|
SCRN COLONOSCOPY PT NOT HI RISK
|
HCPCS
|
If the patient is at high risk for colorectal cancer, the frequency may be more often. Patients at high risk for colon cancer generally have one or more of the following characteristics –
- Close family member (sister, brother, parent, child) who has had colorectal cancer or an adenomatous polyp
- Family history of adenomatous polyposis or hereditary non-polyposis colorectal cancer
- Personal history of adenomatous polyps, colorectal cancer or inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
HCPCS Codes for Reporting Colon Cancer Screening Services
In most cases, HCPCS Level II codes are used to report colon cancer screening services for Medicare patients. - G0121 – Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk(This code is billed for patients who are receiving a routine colon cancer screening and are not at high risk for developing the condition. Medicare covers this service once every 10 years. At least 47 months must have passed following the month in which the patient received a covered screening flexible sigmoidoscopy.
|
G0121
|
SCRN COLONOSCOPY PT NOT HI RISK
|
HCPCS
|
Patients at high risk for colon cancer generally have one or more of the following characteristics –
- Close family member (sister, brother, parent, child) who has had colorectal cancer or an adenomatous polyp
- Family history of adenomatous polyposis or hereditary non-polyposis colorectal cancer
- Personal history of adenomatous polyps, colorectal cancer or inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
HCPCS Codes for Reporting Colon Cancer Screening Services
In most cases, HCPCS Level II codes are used to report colon cancer screening services for Medicare patients. - G0121 – Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk(This code is billed for patients who are receiving a routine colon cancer screening and are not at high risk for developing the condition. Medicare covers this service once every 10 years. At least 47 months must have passed following the month in which the patient received a covered screening flexible sigmoidoscopy. Code G0121 and diagnosis code Z12.11 Encounter for screening for malignant neoplasm of colon are appropriate for a routine screening colonoscopy with no abnormal findings).
|
00811
|
ANES LWR INTST NDSC NOS
|
CPT
|
ICD-10 Diagnosis Codes for Colon Cancer (specific to the location of the cancer)
- C18 Malignant neoplasm of colon
- C18.0 Malignant neoplasm of cecum
- C18.1 Malignant neoplasm of appendix
- C18.2 Malignant neoplasm of ascending colon
- C18.3 Malignant neoplasm of hepatic flexure
- C18.4 Malignant neoplasm of transverse colon
- C18.5 Malignant neoplasm of splenic flexure
- C18.6 Malignant neoplasm of descending colon
- C18.7 Malignant neoplasm of sigmoid colon
- C18.8 Malignant neoplasm of overlapping sites of colon
- C18.9 Malignant neoplasm of colon, unspecified
- C19 Malignant neoplasm of rectosigmoid junction
- C20 Malignant neoplasm of rectum
- C21 Malignant neoplasm of anus and anal canal
- C21.0 Malignant neoplasm of anus, unspecified
- C21.1 Malignant neoplasm of anal canal
- C21.2 Malignant neoplasm of cloacogenic zone
- C21.8 Malignant neoplasm of overlapping sites of rectum, anus and anal canal
Alternative Screening Test
People with Medicare who don’t show symptoms of colorectal cancer will have access to the Cologuard™ – a home screening test that detects certain DNA markers and blood in the test-taker’s stool. This way, physicians can find these polyps and you can get them removed before they turn into cancer. Found to detect 92 percent of colon cancers and 42 percent of high-risk pre-cancers, most payers cover Cologuard™ under a preventive care benefit. Patients should discuss results with their healthcare provider to determine when they should be re-screened or if further testing is necessary. CPT Codes for Colorectal Cancer
- 00811 Anesthesia for lower intestinal endoscopic procedures, endoscopy introduced distal to duodenum; not otherwise specified
- 00812 Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy
- 74263 Computed tomographic (CT) colonography, screening, including image post processing (Non-Covered)
- 81528 Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool, algorithm reported as a positive or negative result
- 82270 Blood, occult, by peroxidase activity (e.g., guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (i.e., patient was provided 3 cards or single triple card for consecutive collection)
Healthcare providers need to remain updated about the specific medical codes and the related screening guidelines to report colorectal cancer correctly.
|
00812
|
ANES LWR INTST SCR COLSC
|
CPT
|
ICD-10 Diagnosis Codes for Colon Cancer (specific to the location of the cancer)
- C18 Malignant neoplasm of colon
- C18.0 Malignant neoplasm of cecum
- C18.1 Malignant neoplasm of appendix
- C18.2 Malignant neoplasm of ascending colon
- C18.3 Malignant neoplasm of hepatic flexure
- C18.4 Malignant neoplasm of transverse colon
- C18.5 Malignant neoplasm of splenic flexure
- C18.6 Malignant neoplasm of descending colon
- C18.7 Malignant neoplasm of sigmoid colon
- C18.8 Malignant neoplasm of overlapping sites of colon
- C18.9 Malignant neoplasm of colon, unspecified
- C19 Malignant neoplasm of rectosigmoid junction
- C20 Malignant neoplasm of rectum
- C21 Malignant neoplasm of anus and anal canal
- C21.0 Malignant neoplasm of anus, unspecified
- C21.1 Malignant neoplasm of anal canal
- C21.2 Malignant neoplasm of cloacogenic zone
- C21.8 Malignant neoplasm of overlapping sites of rectum, anus and anal canal
Alternative Screening Test
People with Medicare who don’t show symptoms of colorectal cancer will have access to the Cologuard™ – a home screening test that detects certain DNA markers and blood in the test-taker’s stool. This way, physicians can find these polyps and you can get them removed before they turn into cancer. Found to detect 92 percent of colon cancers and 42 percent of high-risk pre-cancers, most payers cover Cologuard™ under a preventive care benefit. Patients should discuss results with their healthcare provider to determine when they should be re-screened or if further testing is necessary. CPT Codes for Colorectal Cancer
- 00811 Anesthesia for lower intestinal endoscopic procedures, endoscopy introduced distal to duodenum; not otherwise specified
- 00812 Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy
- 74263 Computed tomographic (CT) colonography, screening, including image post processing (Non-Covered)
- 81528 Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool, algorithm reported as a positive or negative result
- 82270 Blood, occult, by peroxidase activity (e.g., guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (i.e., patient was provided 3 cards or single triple card for consecutive collection)
Healthcare providers need to remain updated about the specific medical codes and the related screening guidelines to report colorectal cancer correctly.
|
1528
|
New Technology - Level 28
|
APC
|
Found to detect 92 percent of colon cancers and 42 percent of high-risk pre-cancers, most payers cover Cologuard™ under a preventive care benefit. Patients should discuss results with their healthcare provider to determine when they should be re-screened or if further testing is necessary. CPT Codes for Colorectal Cancer
- 00811 Anesthesia for lower intestinal endoscopic procedures, endoscopy introduced distal to duodenum; not otherwise specified
- 00812 Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy
- 74263 Computed tomographic (CT) colonography, screening, including image post processing (Non-Covered)
- 81528 Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool, algorithm reported as a positive or negative result
- 82270 Blood, occult, by peroxidase activity (e.g., guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (i.e., patient was provided 3 cards or single triple card for consecutive collection)
Healthcare providers need to remain updated about the specific medical codes and the related screening guidelines to report colorectal cancer correctly. Paying close attention to coding guidelines and payer policies when billing any procedure or service is crucial as this will give you the knowledge to code with accuracy. Relying on medical billing services offered by AAPC-certified billers and coders can help physicians optimize reimbursement for the services they offer.
|
00811
|
ANES LWR INTST NDSC NOS
|
CPT
|
Found to detect 92 percent of colon cancers and 42 percent of high-risk pre-cancers, most payers cover Cologuard™ under a preventive care benefit. Patients should discuss results with their healthcare provider to determine when they should be re-screened or if further testing is necessary. CPT Codes for Colorectal Cancer
- 00811 Anesthesia for lower intestinal endoscopic procedures, endoscopy introduced distal to duodenum; not otherwise specified
- 00812 Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy
- 74263 Computed tomographic (CT) colonography, screening, including image post processing (Non-Covered)
- 81528 Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool, algorithm reported as a positive or negative result
- 82270 Blood, occult, by peroxidase activity (e.g., guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (i.e., patient was provided 3 cards or single triple card for consecutive collection)
Healthcare providers need to remain updated about the specific medical codes and the related screening guidelines to report colorectal cancer correctly. Paying close attention to coding guidelines and payer policies when billing any procedure or service is crucial as this will give you the knowledge to code with accuracy. Relying on medical billing services offered by AAPC-certified billers and coders can help physicians optimize reimbursement for the services they offer.
|
00812
|
ANES LWR INTST SCR COLSC
|
CPT
|
Found to detect 92 percent of colon cancers and 42 percent of high-risk pre-cancers, most payers cover Cologuard™ under a preventive care benefit. Patients should discuss results with their healthcare provider to determine when they should be re-screened or if further testing is necessary. CPT Codes for Colorectal Cancer
- 00811 Anesthesia for lower intestinal endoscopic procedures, endoscopy introduced distal to duodenum; not otherwise specified
- 00812 Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy
- 74263 Computed tomographic (CT) colonography, screening, including image post processing (Non-Covered)
- 81528 Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool, algorithm reported as a positive or negative result
- 82270 Blood, occult, by peroxidase activity (e.g., guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (i.e., patient was provided 3 cards or single triple card for consecutive collection)
Healthcare providers need to remain updated about the specific medical codes and the related screening guidelines to report colorectal cancer correctly. Paying close attention to coding guidelines and payer policies when billing any procedure or service is crucial as this will give you the knowledge to code with accuracy. Relying on medical billing services offered by AAPC-certified billers and coders can help physicians optimize reimbursement for the services they offer.
|
0853
|
Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Home Equipment
|
RC
|
You may turn in the CASE STUDY early (no earlier than October 25 th ). It will be due
GAIN and DSM GAIN National Clinical Training Team 2011 Version 2 Materials Presentation Objectives Understand which DSM diagnoses are generated by GAIN ABS for the GAIN reports and which ones must be added
Guidelines for Understanding and Serving People with Intellectual Disabilities and Mental, Emotional, and Behavioral Disorders Contract Number 732HC08B Prepared by Human Systems and Outcomes, Inc. Edited
Serious Mental Illness (SMI) SMI determination is based on the age of the individual, functional impairment, duration of the disorder and the diagnoses. Adults must meet all of the following five criteria:
Mental Health ICD-10 Codes Department of Health and Mental Hygiene (2) For dates of service on or after October 1, 2015: F200 F201 F202 F203 F205 F2081 F2089 F209 F21 F22 F23 F24 F250 F251 F258 F259 F28
Description Methodology Rationale Measurement Period A measure of the percentage of adults patients who have reached remission at six months (+/- 30 days) after being identified as having an initial PHQ-9
Mr. Pustay AP PSYCHOLOGY AP PSYCHOLOGY CASE STUDY OVERVIEW: We will do only one RESEARCH activity this academic year. You may turn in the CASE STUDY early (no earlier than MID-TERM date). It will be due
Mental health issues in the elderly January 28th 2008 Presented by Éric R. Thériault [email protected] Cognitive Disorders Outline Dementia (294.xx) Dementia of the Alzheimer's Type (early and late
Children s Community Health Plan INTENSIVE IN-HOME MENTAL HEALTH / SUBSTANCE ABUSE SERVICES ASSESSMENT AND RECOVERY / TREATMENT PLAN ATTACHMENT Please fax with CCHP prior authorization form to 608-252-0853
Page 1 of 5 Mental Illness and Intellectual Disability A review of Diagnostic Manual Intellectual Disability: A Textbook of Diagnosis of Mental Disorders in Persons with Intellectual Disability by Robert
Understanding Mental Health Conditions Mental health conditions can affect anyone, including people with developmental disabilities.
|
0853
|
Continuous Cycling Peritoneal Dialysis (CCPD) - Outpatient or Home - Home Equipment
|
RC
|
Adults must meet all of the following five criteria:
Mental Health ICD-10 Codes Department of Health and Mental Hygiene (2) For dates of service on or after October 1, 2015: F200 F201 F202 F203 F205 F2081 F2089 F209 F21 F22 F23 F24 F250 F251 F258 F259 F28
Description Methodology Rationale Measurement Period A measure of the percentage of adults patients who have reached remission at six months (+/- 30 days) after being identified as having an initial PHQ-9
Mr. Pustay AP PSYCHOLOGY AP PSYCHOLOGY CASE STUDY OVERVIEW: We will do only one RESEARCH activity this academic year. You may turn in the CASE STUDY early (no earlier than MID-TERM date). It will be due
Mental health issues in the elderly January 28th 2008 Presented by Éric R. Thériault [email protected] Cognitive Disorders Outline Dementia (294.xx) Dementia of the Alzheimer's Type (early and late
Children s Community Health Plan INTENSIVE IN-HOME MENTAL HEALTH / SUBSTANCE ABUSE SERVICES ASSESSMENT AND RECOVERY / TREATMENT PLAN ATTACHMENT Please fax with CCHP prior authorization form to 608-252-0853
Page 1 of 5 Mental Illness and Intellectual Disability A review of Diagnostic Manual Intellectual Disability: A Textbook of Diagnosis of Mental Disorders in Persons with Intellectual Disability by Robert
Understanding Mental Health Conditions Mental health conditions can affect anyone, including people with developmental disabilities. In fact, there is a special term used to describe having both a diagnosis
INFORMATION SHEET Age Group: Sheet Title: Adults Depression or Mental Health Problems People with Asperger s Syndrome are particularly vulnerable to mental health problems such as anxiety and depression,
Covered Diagnoses & Crosswalk of DSM-IV Codes to ICD-9-CM Codes What is the crosswalk? The crosswalk is a document designed to help you determine which ICD-9-CM diagnosis code corresponds to a particular
Personality Disorders (PD) Summary (print version) 1/ Definition A Personality Disorder is an abnormal, extreme and persistent variation from the normal (statistical) range of one or more personality attributes
Mental Health Needs Assessment Personality Disorder Prevalence and models of care Introduction and definitions Personality disorders are a complex group of conditions identified through how an individual
UNDERSTANDING CO-OCCURRING DISORDERS Frances A. Campbell MSN, PMH CNS-BC, CARN Michael Beatty, LCSW, NCGC-1 Bridge To Hope November 18, 2015 CO-OCCURRING DISORDERS What does it really mean CO-OCCURRING
Addictions and Mental Health Division Programs Central Intake Referral Form The Central Intake Referral Form is used in the District of Nipissing by the North Bay Regional Health Centre s Addictions and
Florida Medicaid: Mental Health and Substance Abuse Services Beth Kidder Assistant Deputy Secretary for Medicaid Operations Agency for Health Care Administration House Children, Families, and Seniors Subcommittee
Abnormal Psychology PSY-350-TE This TECEP tests the material usually taught in a one-semester course in abnormal psychology.
|
0622
|
Medical/Surgical Supplies and Devices - Extension of 027x - Supplies Incident to Other DX Services
|
RC
|
There are two main types of bipolar illness: bipolar I and bipolar II. In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated
PHENOTYPE PROCESSING METHODS. We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions.
|
0305
|
Thrombin time, fibrinogen screening test, plasma
|
RC
|
There are two main types of bipolar illness: bipolar I and bipolar II. In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated
PHENOTYPE PROCESSING METHODS. We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions.
|
0145
|
Med-Surg
|
RC
|
There are two main types of bipolar illness: bipolar I and bipolar II. In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated
PHENOTYPE PROCESSING METHODS. We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions.
|
0622
|
Medical/Surgical Supplies and Devices - Extension of 027x - Supplies Incident to Other DX Services
|
RC
|
In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated
PHENOTYPE PROCESSING METHODS. We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. These disorders cause people to lose touch with reality.
|
0305
|
Thrombin time, fibrinogen screening test, plasma
|
RC
|
In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated
PHENOTYPE PROCESSING METHODS. We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. These disorders cause people to lose touch with reality.
|
0145
|
Med-Surg
|
RC
|
In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated
PHENOTYPE PROCESSING METHODS. We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. These disorders cause people to lose touch with reality.
|
0622
|
Medical/Surgical Supplies and Devices - Extension of 027x - Supplies Incident to Other DX Services
|
RC
|
We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. These disorders cause people to lose touch with reality. As a result, people
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Cardwell C Nuckols, PhD [email protected] Cardwell C. Nuckols, PhD www.cnuckols.com SECTION I-BASICS DSM-5 Includes
Phenotype Processing Algorithm 1.
|
0305
|
Thrombin time, fibrinogen screening test, plasma
|
RC
|
We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. These disorders cause people to lose touch with reality. As a result, people
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Cardwell C Nuckols, PhD [email protected] Cardwell C. Nuckols, PhD www.cnuckols.com SECTION I-BASICS DSM-5 Includes
Phenotype Processing Algorithm 1.
|
0145
|
Med-Surg
|
RC
|
We first applied exclusionary criteria, recoding diagnosed individuals as phenotype unknown in the presence of: all dementias, amnestic and cognitive disorders; unknown/unspecified
www.bhcsct.org [email protected] 46 West Avon Road 322 Main St. 530 Middlebury Road Suite 202 Suite 1-G Suite 103 B Avon, CT 06001 Willimantic, CT 06226 Middlebury, CT 06762 Office phone- 1-860-673-0145
Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious
DEPRESSION CODING FACT SHEET FOR PRIMARY CARE CLINICIANS Current Procedural Terminology (CPT ) (Procedure) Codes Initial assessment usually involves a lot of time determining the differential diagnosis,
RAPt RESEARCH AND POLICY BRIEFING SERIES No.2 Substance misuse and mental health in prison 12th May 2015 FOREWORD This series of RAPt Research and Policy Briefings aims to synthesise over 20 years of practical
Provider Notice 1.13 May 30, 2008»» Pre-Authorization 1915(b) Service 1915(b) Attendant Care Services (CPT T1019HE) and 1915(b) Case Conference services (CPT 99366, 99367, 99368) are pre-authorized services
Behavioral Health Best Practice Documentation Click on the desired Diagnoses link or press Enter to view all information. Diagnoses: DSM-5 and ICD-10 Codes Major Depressive Disorder Bipolar Disorder Eating
Mental Health Ombudsman Training Manual Advocacy and the Adult Home Resident Module V: Substance Abuse and Common Mental Health Disorders S WEHRY 2004 Goals Increase personal comfort and confidence Increase
Designing school supported work experiences Dawn Breault MA, C.R.C. District Transition Counselor Alvirne High School 200 Derry Rd Hudson, NH 03051 Interagency Collaboration We could learn a lot from crayons:
Dual Diagnosis Treatment Team (DDT T) Objectives To gain an overall understanding of the structure of the DDTT To understand the dynamics of this team s approach To understand the effectiveness of this
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. These disorders cause people to lose touch with reality. As a result, people
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Cardwell C Nuckols, PhD [email protected] Cardwell C. Nuckols, PhD www.cnuckols.com SECTION I-BASICS DSM-5 Includes
Phenotype Processing Algorithm 1.
|
00100
|
ANESTH SALIVARY GLAND
|
CPT
|
Each CPT code consists of a five-digit numeric or alphanumeric version. Wide ranges of coding benefit all parties, and are focused on a common set of standards so diverse users have an overall understanding across the healthcare spectrum. Listed below are the various types of CPT codes:
- Category I: The first level of CPT coding has descriptors corresponding to a specific procedure or service. Codes range from 00100 to 99499. - Category II: The second level of CPT coding is utilized for performance measurement.
|
00100
|
ANESTH SALIVARY GLAND
|
CPT
|
Wide ranges of coding benefit all parties, and are focused on a common set of standards so diverse users have an overall understanding across the healthcare spectrum. Listed below are the various types of CPT codes:
- Category I: The first level of CPT coding has descriptors corresponding to a specific procedure or service. Codes range from 00100 to 99499. - Category II: The second level of CPT coding is utilized for performance measurement. Alphanumeric codes are supplemental and not required for the coding process.
|
00100
|
ANESTH SALIVARY GLAND
|
CPT
|
Listed below are the various types of CPT codes:
- Category I: The first level of CPT coding has descriptors corresponding to a specific procedure or service. Codes range from 00100 to 99499. - Category II: The second level of CPT coding is utilized for performance measurement. Alphanumeric codes are supplemental and not required for the coding process. - Category III: The third level of CPT coding uses alphanumeric labeling for medical providers developing new technology, procedures, and services.
|
95810
|
Sleep study in sleep lab (6 years or older)
|
HCPCS
|
Although there is no cure for this sleep condition, the symptoms (EDS and symptoms of abnormal REM sleep, such as cataplexy) can be controlled in most people with drug treatment. Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging.
|
95807
|
Sleep study including heart rate and breathing attended by technician
|
HCPCS
|
Although there is no cure for this sleep condition, the symptoms (EDS and symptoms of abnormal REM sleep, such as cataplexy) can be controlled in most people with drug treatment. Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging.
|
95811
|
SLEEP STUDY W INTITIATION OF CPAP TX/VEN
|
HCPCS
|
Although there is no cure for this sleep condition, the symptoms (EDS and symptoms of abnormal REM sleep, such as cataplexy) can be controlled in most people with drug treatment. Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging.
|
G0400
|
PR HOME SLEEP TEST/TYPE 4 PORTA
|
HCPCS
|
Although there is no cure for this sleep condition, the symptoms (EDS and symptoms of abnormal REM sleep, such as cataplexy) can be controlled in most people with drug treatment. Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging.
|
95801
|
Slp stdy unatnd w/anal
|
HCPCS
|
Although there is no cure for this sleep condition, the symptoms (EDS and symptoms of abnormal REM sleep, such as cataplexy) can be controlled in most people with drug treatment. Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging.
|
95806
|
Sleep study unatt&resp efft
|
HCPCS
|
Although there is no cure for this sleep condition, the symptoms (EDS and symptoms of abnormal REM sleep, such as cataplexy) can be controlled in most people with drug treatment. Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging.
|
95805
|
Sleep study, multiple trials
|
HCPCS
|
Although there is no cure for this sleep condition, the symptoms (EDS and symptoms of abnormal REM sleep, such as cataplexy) can be controlled in most people with drug treatment. Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging.
|
95782
|
PR POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND
|
HCPCS
|
Although there is no cure for this sleep condition, the symptoms (EDS and symptoms of abnormal REM sleep, such as cataplexy) can be controlled in most people with drug treatment. Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging.
|
G0398
|
PR HOME SLEEP TEST/TYPE 2 PORTA
|
HCPCS
|
Although there is no cure for this sleep condition, the symptoms (EDS and symptoms of abnormal REM sleep, such as cataplexy) can be controlled in most people with drug treatment. Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging.
|
G0399
|
PR HOME SLEEP TEST/TYPE 3 PORTA
|
HCPCS
|
Although there is no cure for this sleep condition, the symptoms (EDS and symptoms of abnormal REM sleep, such as cataplexy) can be controlled in most people with drug treatment. Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging.
|
95800
|
Slp stdy unattended
|
HCPCS
|
Although there is no cure for this sleep condition, the symptoms (EDS and symptoms of abnormal REM sleep, such as cataplexy) can be controlled in most people with drug treatment. Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging.
|
95808
|
PR POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND
|
HCPCS
|
Although there is no cure for this sleep condition, the symptoms (EDS and symptoms of abnormal REM sleep, such as cataplexy) can be controlled in most people with drug treatment. Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging.
|
95803
|
PR ACTIGRAPHY TESTING RECORDING ANALYSIS I&R
|
HCPCS
|
Although there is no cure for this sleep condition, the symptoms (EDS and symptoms of abnormal REM sleep, such as cataplexy) can be controlled in most people with drug treatment. Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging.
|
95783
|
PR POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM
|
HCPCS
|
Although there is no cure for this sleep condition, the symptoms (EDS and symptoms of abnormal REM sleep, such as cataplexy) can be controlled in most people with drug treatment. Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging.
|
95810
|
Sleep study in sleep lab (6 years or older)
|
HCPCS
|
Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help.
|
95807
|
Sleep study including heart rate and breathing attended by technician
|
HCPCS
|
Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help.
|
95811
|
SLEEP STUDY W INTITIATION OF CPAP TX/VEN
|
HCPCS
|
Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help.
|
G0400
|
PR HOME SLEEP TEST/TYPE 4 PORTA
|
HCPCS
|
Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help.
|
95801
|
Slp stdy unatnd w/anal
|
HCPCS
|
Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help.
|
95806
|
Sleep study unatt&resp efft
|
HCPCS
|
Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help.
|
95805
|
Sleep study, multiple trials
|
HCPCS
|
Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help.
|
95782
|
PR POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND
|
HCPCS
|
Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help.
|
G0398
|
PR HOME SLEEP TEST/TYPE 2 PORTA
|
HCPCS
|
Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help.
|
G0399
|
PR HOME SLEEP TEST/TYPE 3 PORTA
|
HCPCS
|
Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help.
|
95800
|
Slp stdy unattended
|
HCPCS
|
Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help.
|
95808
|
PR POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND
|
HCPCS
|
Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help.
|
95803
|
PR ACTIGRAPHY TESTING RECORDING ANALYSIS I&R
|
HCPCS
|
Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help.
|
95783
|
PR POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM
|
HCPCS
|
Medications include – Stimulants (like Modafinil (Provigil) or Armodafinil (Nuvigil), Amphetamine-like stimulants, Methylphenidate (Aptensio XR, Concerta, and Ritalin), Sodium oxybate and other antidepressant drugs. Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help.
|
95810
|
Sleep study in sleep lab (6 years or older)
|
HCPCS
|
Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help. Taking adequate safety precautions, (particularly when driving) is important for people with narcolepsy.
|
95807
|
Sleep study including heart rate and breathing attended by technician
|
HCPCS
|
Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help. Taking adequate safety precautions, (particularly when driving) is important for people with narcolepsy.
|
95811
|
SLEEP STUDY W INTITIATION OF CPAP TX/VEN
|
HCPCS
|
Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help. Taking adequate safety precautions, (particularly when driving) is important for people with narcolepsy.
|
G0400
|
PR HOME SLEEP TEST/TYPE 4 PORTA
|
HCPCS
|
Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help. Taking adequate safety precautions, (particularly when driving) is important for people with narcolepsy.
|
95801
|
Slp stdy unatnd w/anal
|
HCPCS
|
Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help. Taking adequate safety precautions, (particularly when driving) is important for people with narcolepsy.
|
95806
|
Sleep study unatt&resp efft
|
HCPCS
|
Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help. Taking adequate safety precautions, (particularly when driving) is important for people with narcolepsy.
|
95805
|
Sleep study, multiple trials
|
HCPCS
|
Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help. Taking adequate safety precautions, (particularly when driving) is important for people with narcolepsy.
|
95782
|
PR POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND
|
HCPCS
|
Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help. Taking adequate safety precautions, (particularly when driving) is important for people with narcolepsy.
|
G0398
|
PR HOME SLEEP TEST/TYPE 2 PORTA
|
HCPCS
|
Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help. Taking adequate safety precautions, (particularly when driving) is important for people with narcolepsy.
|
G0399
|
PR HOME SLEEP TEST/TYPE 3 PORTA
|
HCPCS
|
Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help. Taking adequate safety precautions, (particularly when driving) is important for people with narcolepsy.
|
95800
|
Slp stdy unattended
|
HCPCS
|
Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help. Taking adequate safety precautions, (particularly when driving) is important for people with narcolepsy.
|
95808
|
PR POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND
|
HCPCS
|
Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help. Taking adequate safety precautions, (particularly when driving) is important for people with narcolepsy.
|
95803
|
PR ACTIGRAPHY TESTING RECORDING ANALYSIS I&R
|
HCPCS
|
Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help. Taking adequate safety precautions, (particularly when driving) is important for people with narcolepsy.
|
95783
|
PR POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM
|
HCPCS
|
Incorporating lifestyle adjustments such avoiding the intake of caffeine, alcohol and nicotine, regulating sleep schedules, establishing a normal exercise pattern and meal schedule and scheduling short naps (10-15 minutes in length) at regular intervals during the day may help reduce symptoms in the long-run. Allergy and sleep medicine medical coding involves using the specific ICD-10 diagnosis codes, CPT codes and HCPCS codes for reporting narcolepsy on the medical claims providers submit to health insurers for reimbursement. ICD-10 Codes to Use for “Narcolepsy”
G47.4 – Narcolepsy and cataplexy
G47.41 – Narcolepsy
- G47.411 – Narcolepsy and cataplexy, with cataplexy
- G47.419 – Narcolepsy and cataplexy, without cataplexy
G47.42 – Narcolepsy in conditions classified elsewhere
- G47.421 – Narcolepsy in conditions classified elsewhere, with cataplexy
- G47.429 – Narcolepsy in conditions classified elsewhere, without cataplexy
CPT Codes for Narcolepsy Diagnostic Testing
- 95782 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
- 95783 – Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of Continuous Positive Airway Pressure therapy or bi-level ventilation, attended by a technologist
- 95800 – Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time
- 95801 – Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone)
- 95803 – Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)
- 95805- Multiple Sleep Latency or Maintenance Of Wakefulness Testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness
- 95806 – Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (e.g., thoraco abdominal movement)
- 95807 – Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist
- 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 bi-level ventilation, attended by a technologist
- G0398 – Home Sleep Study Test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation
- G0399 – Home Sleep Test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation
- G0400 – Home Sleep Test (HST) with type IV portable monitor, unattended; minimum of 3 channels
Dealing with narcolepsy can be challenging. Making necessary adjustments in your daily schedule may help. Taking adequate safety precautions, (particularly when driving) is important for people with narcolepsy.
|
1500
|
New Technology - Level 1
|
APC
|
The American Academy of Professionals Coders (AAPC) provides physician-based coding certification courses, such as CPC certification. The organization offers both classroom and online training, which can be completed in less than 5 months. The course fee is $1500. The American Health Information Management Association (AHIMA) offers facility-based training courses – both certificate and degree programs. The coding training with AHIMA usually takes about 15 months to complete.
|
31254
|
PR NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated.
|
31294
|
PR NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated.
|
61548
|
Removal of pituitary gland
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated.
|
31288
|
PR NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated.
|
1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated.
|
G0340
|
Robt lin-radsurg fractx 2-5
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated.
|
31287
|
PR NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated.
|
G0339
|
Robot lin-radsurg com, first
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated.
|
31276
|
PR NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated.
|
S8030
|
Tantalum ring application
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated.
|
31290
|
PR NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated.
|
31256
|
PR NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated.
|
31267
|
PR NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated.
|
61795
|
Brain surgery using computer
|
HCPCS
|
For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated.
|
31254
|
PR NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated.
|
31294
|
PR NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated.
|
61548
|
Removal of pituitary gland
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated.
|
31288
|
PR NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated.
|
1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated.
|
G0340
|
Robt lin-radsurg fractx 2-5
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated.
|
31287
|
PR NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated.
|
G0339
|
Robot lin-radsurg com, first
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated.
|
31276
|
PR NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated.
|
S8030
|
Tantalum ring application
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated.
|
31290
|
PR NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated.
|
31256
|
PR NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated.
|
31267
|
PR NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated.
|
61795
|
Brain surgery using computer
|
HCPCS
|
In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting. POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated.
|
31254
|
PR NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY
|
HCPCS
|
POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated. CPT code 61795 deleted.
|
31294
|
PR NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN
|
HCPCS
|
POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated. CPT code 61795 deleted.
|
61548
|
Removal of pituitary gland
|
HCPCS
|
POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated. CPT code 61795 deleted.
|
31288
|
PR NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS
|
HCPCS
|
POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated. CPT code 61795 deleted.
|
1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
POLICY HISTORY9/1992: Approved by Medical Policy Advisory Committee (MPAC)
9/1994: Reviewed and updated by MPAC
10/1996: Reviewed and updated by MPAC
2/2001: Reviewed by MPAC; Proton beam therapy for prostate cancer considered investigational
4/3/2001: Code Reference updated
5/8/2001: Proton Beam is medically necessary for early stage, surgically inoperable non-small cell lung cancer. 9/5/2001: Trigeminal Neuralgia refractory to medical management added as covered indication
2/13/2002: Investigational definition added
3/5/2002: Prior authorization added
3/12/2002: New 2002 codes added
5/8/2002: Type of Service and Place of Service deleted
9/20/2002: Policy reviewed, Hayes report number added
12/4/2002: Hayes report number deleted
12/11/2002: HCPCS S8030 added
1/17/2003: Policy section updated
3/7/2003: Code Reference section updated
8/20/2003: ICD-9 procedure code range 92.30-92.39 listed separately, ICD-9 diagnosis code ranges 162.0-162.9, 191.0-191.9 listed separately
6/3/2004: HCPCS G0338, G0339, G0340 added to covered codes
2/11/2005: CPT code 61795 Note: "It is appropriate for providers to report 61795 when performed in conjunction with ENT, head, and neck procedures, including functional endoscopic sinus surgeries (FESS). Some examples would include those procedures described by codes 31254-31256, 31267, 31276, 31287, 31288, 31290-31294, and 61548" added, for clarification of CPT code 61795 "Note" added to See "Policy"section for specific coverage of Stereotactic Radiosurgery
3/14/2006: Coding updated. HCPCS 2005 revisions added to policy
7/20/2006: Policy reviewed, prior authorization removed
8/18/2006: Policy and description rewritten and clarified; investigational status of extracranial sites added
9/5/2006: Code reference section udpated. CPT code 61795 deleted.
|
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