How To Use CPT Code 95807

CPT 95807 describes the process of conducting a sleep study with the presence of a technologist. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 95807?

CPT 95807 can be used to describe the process of conducting a sleep study with the assistance of a technologist. This code is used when various parameters, such as ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, are simultaneously recorded while the patient is asleep. The presence of a technologist ensures accurate monitoring and data collection during the study.

2. Official Description

The official description of CPT code 95807 is: ‘Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist.’

3. Procedure

1. A technologist is present during the sleep study to record and monitor several parameters.
2. The patient sleeps in a clinic or sleep lab while the technologist records ventilation, respiratory effort, ECG or heart rate, and oxygen saturation.
3. The recorded data is then used by a physician to interpret the results and diagnose any sleep disorders.

4. Qualifying circumstances

CPT 95807 is used when a sleep study is conducted with the assistance of a technologist. This code is applicable when parameters such as ventilation, respiratory effort, ECG or heart rate, and oxygen saturation are simultaneously recorded during the study. The presence of a technologist ensures accurate monitoring and data collection, which is crucial for an accurate diagnosis of sleep disorders.

5. When to use CPT code 95807

CPT code 95807 should be used when conducting a sleep study that involves the simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation. The presence of a technologist is necessary to ensure accurate monitoring and data collection during the study. This code should not be used for sleep studies that do not involve the simultaneous recording of these parameters or when a technologist is not present.

6. Documentation requirements

To support a claim for CPT 95807, the following documentation is required:

• Record of the parameters monitored during the sleep study, including ventilation, respiratory effort, ECG or heart rate, and oxygen saturation
• Date and duration of the sleep study
• Documentation of the presence of a technologist during the study
• Physician’s interpretation of the results and diagnosis of any sleep disorders

7. Billing guidelines

When billing for CPT 95807, ensure that the sleep study involves the simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation. The presence of a technologist during the study is also necessary. If only the physician’s interpretation is being reported, append modifier 26 to the code. If only the technical component is being reported, append modifier TC to the code. Do not append any modifiers if reporting a global service where one provider renders both the professional and technical components.

8. Historical information

CPT 95807 was added to the Current Procedural Terminology system on January 1, 1994. There have been no updates to the code since its addition.

9. Examples

1. A sleep study conducted with the presence of a technologist, recording ventilation, respiratory effort, ECG or heart rate, and oxygen saturation to diagnose sleep apnea.
2. A patient undergoing a sleep study with the assistance of a technologist, monitoring various parameters to assess the presence of periodic limb movement disorder.
3. A sleep study conducted with the simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist, to evaluate the presence of narcolepsy.
4. A patient undergoing a sleep study with the presence of a technologist, monitoring ventilation, respiratory effort, ECG or heart rate, and oxygen saturation to diagnose REM sleep behavior disorder.
5. A sleep study conducted with the assistance of a technologist, recording various parameters to assess the presence of insomnia in a patient.
6. A patient undergoing a sleep study with the simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist, to evaluate the presence of restless legs syndrome.
7. A sleep study conducted with the presence of a technologist, monitoring ventilation, respiratory effort, ECG or heart rate, and oxygen saturation to diagnose sleep-related hypoventilation.
8. A patient undergoing a sleep study with the assistance of a technologist, recording various parameters to assess the presence of sleep-related eating disorder.
9. A sleep study conducted with the simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist, to evaluate the presence of circadian rhythm sleep-wake disorder.
10. A patient undergoing a sleep study with the presence of a technologist, monitoring ventilation, respiratory effort, ECG or heart rate, and oxygen saturation to diagnose sleep-related movement disorder.