Billing for visits+study

[SleepMD1]

Hi everyone,

Just started my first attending job after fellowship doing a combo of peds and peds sleep. However, the sleep clinic is not set up yet and I was asked if screening visits before psg and follow up visits after can be billed as part of the sleep study?

Does anyone know or have tips about where I can find out???

Thanks!

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[michaelrack]

I assume you are working at a hospital associated sleep lab. I don't think you can bill patient visits as part of the sleep study. I believe you would have to bill it separately as an outpatient visit- the way it would be billed once the sleep clinic is set up. Talk to the billing dept. Even if the sleep clinic isn't set up yet, you should still be able to bill the patient visit.

I work at a 2 bed hospital assoc sleep lab. I use the normal outpt codes when seeing pts (the billing dept should be able to list the correct site of service on the charge sheet), and 95810-26 or 95811-26 for the prof component of sleep studies I read.

 

[Bobblehead]

One issue we've encountered is that after we read & bill for a sleep study, the billing department has told us that follow-up visits to that sleep study must be billed as a follow-up instead of a new patient clinic encounter although that would be the first time we've seen the person in the office.

As a result we're trying to see more people before they have their sleep study to capture that billing.

 

[SleepMD1]

Thanks so much for the help! This type of info is hard to come across unless you know where to find it..

 

[neurologist]

One issue we've encountered is that after we read & bill for a sleep study, the billing department has told us that follow-up visits to that sleep study must be billed as a follow-up instead of a new patient clinic encounter although that would be the first time we've seen the person in the office.

Huh? A PSG is a diagnostic test. A visit with a patient you've never seen before and do a full evaluation on is a new patient visit, not a followup. Please talk in more detail with your billing dept, 'cause I think they are shortchanging you.

 

[Manicsleep]

Huh? A PSG is a diagnostic test. A visit with a patient you've never seen before and do a full evaluation on is a new patient visit, not a followup. Please talk in more detail with your billing dept, 'cause I think they are shortchanging you.

Exactly. Been doing that for quite some time. Even had a medicare audit. No problems.