How To Use CPT Code 0436T

CPT 0436T describes the evaluation and programming of an implanted neurostimulator pulse generator system for central sleep apnea during a sleep study. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0436T?

CPT 0436T can be used to describe the evaluation and programming services provided by a healthcare provider for an implanted neurostimulator pulse generator system used to treat central sleep apnea. This code is used when the provider performs an analysis and adjustment of the programming parameters of the pulse generator during a sleep study to optimize its functioning.

2. Official Description

The official description of CPT code 0436T is: ‘Programming device evaluation of implanted neurostimulator pulse generator system for central sleep apnea; during sleep study.’

3. Procedure

1. The provider connects a portable programming device to the implanted neurostimulator pulse generator system.
2. During a sleep study (polysomnography), the provider analyzes and reviews various parameters of the stored data, comparing it to current readings.
3. The provider adjusts the programming of the pulse generator to optimize its functioning and evaluates certain aspects of the device function.
4. The provider may make multiple adjustments to the programming during the sleep study session.

4. Qualifying circumstances

Patients eligible to receive CPT 0436T services are those with central sleep apnea who have an implanted neurostimulator pulse generator system. The programming evaluation must be performed during a sleep study, and the provider must analyze and adjust the programming parameters to optimize the functioning of the device.

5. When to use CPT code 0436T

CPT code 0436T should be used when a provider performs an evaluation and programming of an implanted neurostimulator pulse generator system for central sleep apnea during a sleep study. This code should be reported once per sleep study, regardless of the number of adjustments made to the programming.

6. Documentation requirements

To support a claim for CPT 0436T, the provider must document the following information:

• Patient’s diagnosis of central sleep apnea
• Details of the implanted neurostimulator pulse generator system
• Date and duration of the sleep study
• Specific programming adjustments made during the sleep study
• Analysis and review of the stored data
• Report on the optimization of the device functioning
• Signature of the provider performing the evaluation and programming

7. Billing guidelines

When billing for CPT 0436T, ensure that the evaluation and programming are performed during a sleep study and that the provider analyzes and adjusts the programming parameters. Do not report CPT 0436T in conjunction with other codes specified in the notes. Use modifier 26 when reporting this code for professional services.

8. Historical information

CPT 0436T was added to the Current Procedural Terminology system on January 1, 2016. There have been no updates to the code since its addition.

9. Examples

1. A sleep medicine specialist analyzes and adjusts the programming of an implanted neurostimulator pulse generator system for central sleep apnea during a sleep study.
2. A neurologist performs an evaluation and optimization of the programming parameters of an implanted neurostimulator pulse generator system for central sleep apnea during a sleep study.
3. An otolaryngologist reviews and adjusts the programming of an implanted neurostimulator pulse generator system for central sleep apnea to optimize its functioning during a sleep study.
4. A pulmonologist analyzes the stored data and makes programming adjustments to an implanted neurostimulator pulse generator system for central sleep apnea during a sleep study.
5. A sleep medicine nurse practitioner performs an evaluation and programming of an implanted neurostimulator pulse generator system for central sleep apnea during a sleep study.
6. A neurosurgeon reviews the data and adjusts the programming parameters of an implanted neurostimulator pulse generator system for central sleep apnea during a sleep study.
7. An anesthesiologist analyzes and optimizes the programming of an implanted neurostimulator pulse generator system for central sleep apnea during a sleep study.
8. A sleep medicine physician assistant performs an evaluation and programming of an implanted neurostimulator pulse generator system for central sleep apnea during a sleep study.
9. A neurology resident reviews the stored data and makes programming adjustments to an implanted neurostimulator pulse generator system for central sleep apnea during a sleep study.
10. A pulmonology fellow analyzes and adjusts the programming parameters of an implanted neurostimulator pulse generator system for central sleep apnea during a sleep study.