Billing CPT 95810,95808,95807 WITH covered diagnosis

Medicare is establishing the following coverage for CPT/HCPCs 95807, 95808, 95810:

Attended Studies

** CPT Codes: 95807, 95808, 95810, 95811, 95782, 95783. Unattended Study

** CPT Code: 95806 (Note that this CPT code is identical to 95807 except that the study is not monitored.) 95800, 95801 (These differ from 95806 in the description of a single respiratory sensor [either air flow or peripheral arterial tone] instead of the standard configuration of both respiratory effort and respiratory airflow [ventilation]).

** Use of overnight oximetry alone would be indicated by CPT code 94762. HCPCS Codes


** There is 1 HCPCS code identifying a CPAP device, E0601, and 2 HCPCS codes for BiPAP devices: E0470 and E0471. The HCPCS codes do not distinguish among fixed CPAP or BiPAP devices and auto-adjusting CPAP devices.


Covered for ICD-9-CM indications:

278.01 MORBID OBESITY
307.41 - 307.48 TRANSIENT DISORDER OF INITIATING OR MAINTAINING SLEEP - REPETITIVE INTRUSIONS OF SLEEP
327.10 - 327.15 ORGANIC HYPERSOMNIA, UNSPECIFIED - HYPERSOMNIA DUE TO MENTAL DISORDER
327.19 OTHER ORGANIC HYPERSOMNIA
327.20 - 327.27 ORGANIC SLEEP APNEA, UNSPECIFIED - CENTRAL SLEEP APNEA IN CONDITIONS CLASSIFIED ELSEWHERE
327.29 OTHER ORGANIC SLEEP APNEA
327.30 - 327.37 CIRCADIAN RHYTHM SLEEP DISORDER, UNSPECIFIED - CIRCADIAN RHYTHM SLEEP DISORDER IN CONDITIONS CLASSIFIED ELSEWHERE
327.40 - 327.42 ORGANIC PARASOMNIA, UNSPECIFIED - REM SLEEP BEHAVIOR DISORDER
327.44 PARASOMNIA IN CONDITIONS CLASSIFIED ELSEWHERE
327.51 - 327.53 PERIODIC LIMB MOVEMENT DISORDER - SLEEP RELATED BRUXISM
333.2 MYOCLONUS
347.00 - 347.01 NARCOLEPSY, WITHOUT CATAPLEXY - NARCOLEPSY, WITH CATAPLEXY
347.10 - 347.11 NARCOLEPSY IN CONDITIONS CLASSIFIED ELSEWHERE, WITHOUT CATAPLEXY - NARCOLEPSY IN CONDITIONS CLASSIFIED ELSEWHERE, WITH CATAPLEXY
518.83 CHRONIC RESPIRATORY FAILURE
780.50 - 780.51 UNSPECIFIED SLEEP DISTURBANCE - INSOMNIA WITH SLEEP APNEA, UNSPECIFIED
780.53 - 780.58 HYPERSOMNIA WITH SLEEP APNEA, UNSPECIFIED - SLEEP RELATED MOVEMENT DISORDER, UNSPECIFIED
786.04 CHEYNE-STOKES RESPIRATION

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