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Insurance Requests/Auhorization

Preparation of all insurance requests/authorizations and arrangements for consultative services, sleep studies, or CPAP/Bi-Level equipment. 

Procedure(s) requested:

p Initial Sleep Consultation [evaluation for a possible sleep disorder by a physician on CCSD consultative staff].

p Follow-up Sleep Consultation [review of sleep study and discussion of treatment options with the patient by a physician on CCSD consultative staff]. 

p Diagnostic Polysomnogram [A sleep study using 1-4 leads {EEG, EOG, EMG} for sleep staging – plus 4 or more additional parameters of sleep such as EKG, airflow, effort, oximetry, body position]; attended by a technologist.  CPT CODE:  95810

p Split-Night (Diagnostic & Treatment) Polysomnogram with CPAP or Bi-Level Therapy [same as above, except nasal CPAP or Bi-Level therapy is used during the 2nd part of the night]; attended by a technologist.  CPT CODE:  95811

p All Night Polysomnogram with CPAP or Bi-Level Therapy [CPAP or Bi-Level therapy is initiated at the beginning of the night]; attended by a technologist.  CPT CODE:  95811

p Multiple Sleep Latency Test [a series of nap studies performed and generally followed by a polysomnogram for the objective evaluation of daytime sleepiness or suspected Narcolepsy]; attended by a technologist.  CPT CODE:  95805

Treatment Requested:

p Initiate CPAP/Bi-Level Therapy.  NOTE:  If the patient was not seen by our sleep physician(s), a consultation visit is required before CPAP can be prescribed.  CPT CODE:  99245

p Arrange for evaluation, fabrication and fitting of mandibular positioning device.  NOTE:  If the patient was not seen by our sleep physician(s), a consultation visit is required before the device can be made.  CPT CODE:  99022-22

 

 


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