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Polysomnography, as defined by CPT® Code 95808, is a comprehensive sleep study conducted to assess various sleep disorders. This procedure involves sleep staging, which is the classification of different sleep phases, and is performed by a trained sleep technologist. The primary purpose of polysomnography is to evaluate and diagnose a range of sleep-related conditions, including but not limited to sleep apnea, narcolepsy, insomnia, sleepwalking, restless leg syndrome, and other periodic movements that occur during sleep. During the study, the patient arrives at the sleep center in the evening, where the environment is controlled to facilitate accurate monitoring. Sleep staging is achieved through the use of several diagnostic tools, including electroencephalography (EEG) to measure brain activity, electro-oculography (EOG) to track eye movements, and electromyography (EMG) to assess muscle tone. The EEG is conducted using one to four electrodes placed on the scalp, while the EOG involves electrodes positioned around the eyes to capture eye movement. Additionally, a submental EMG is utilized by placing an electrode under the chin to monitor muscle activity. Beyond sleep staging, the study may also include the recording of one to three additional parameters of sleep, such as heart rate and rhythm, airflow, respiratory effort, gas exchange metrics, extremity muscle activity, and other relevant physiological data. The room is kept dark to promote natural sleep, and the technologist records brain activity, eye movements, and muscle tone throughout the night. After the completion of the study, the physician reviews the collected data and provides a detailed written interpretation of the results, which is essential for diagnosing any identified sleep disorders.
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The indications for performing polysomnography (CPT® Code 95808) include the evaluation and diagnosis of various sleep disorders. These conditions may encompass:
The procedure for conducting polysomnography involves several key steps to ensure accurate monitoring and data collection.
Post-procedure care following polysomnography typically involves the patient receiving instructions regarding the next steps based on the findings of the sleep study. The physician will review the results with the patient, discussing any diagnosed sleep disorders and potential treatment options. Patients may be advised on lifestyle modifications, further testing, or therapeutic interventions, such as continuous positive airway pressure (CPAP) therapy if indicated. Follow-up appointments may be scheduled to monitor the patient's progress and response to any prescribed treatments.
| Short Descr | POLYSOM ANY AGE 1-3> PARAM | Medium Descr | POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND | Long Descr | Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Not Discounted when Multiple | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T2D - Other tests - other | MUE | 1 | CCS Clinical Classification | 227 - Other diagnostic procedures (interview, evaluation, consultation) |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles |
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| 2024-01-01 | Changed | Guideline added. |
| 2013-01-01 | Changed | Description Changed |
| 2011-01-01 | Changed | Short description changed. |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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