Friday, November 25, 2005

New Sleep Billing Codes

Does anyone have any experience with the new ICD-9 billing codes for sleep, especially the codes for obstructive sleep apnea (OSA)??
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780.53-0 used to be the code for OSA. Now there are 2 main codes for OSA:
780.53 (hypersomnia with sleep apnea, unspecified) and 327.23 (obstructive sleep apnea).
What I have been doing is using 780.53 for suspected cases of OSA, and 327.23 for confirmed cases. For upper airway resistance syndrome, I usually code 780.53. Does anyone know if this is correct?? Does anyone have any references?? I bought my copy of The International Classification of Sleep Disorders-2nd edition this summer, before the new ICD-9 codes were available. Have ICD-9 codes been added to the International Classification of Sleep Disorders yet?

8 comments:

IndyEllen said...

I work at an ENT practice where we do a lot of the OSA surgeries (UPPP, etc.) and we've been using 327.23 for our pre-determinations, etc. However, even though the new code went into effect 10/1/05, most of the payors don't seem to have bothered to load it into their systems yet and they keep telling us it's an invalid code. *sigh*

I think your split between when to use 780.53 vs. 327.23 seems as logical as anything else, but I haven't heard anything specific.

Ellen Schuck
Medical Billing Specialist
Head & Neck Associates, P.C.
Indianapolis, IN

Michael Rack, MD said...

to Ellen Schuck:
thanks for sharing your experience with the new codes.
Yesterday I was talking to a very helpful employee at Salient Sleep (http://www.salientsleep.com/), and she told me that both the old and new codes are supposed to be accepted from 10/1/05 until 12/31/05, and after that only the new codes are supposed to be accepted. I haven't submitted many bills yet because we are still in the process of getting set up with all of the companies. I think I will submit both codes until 12/31/05.

Lori Genovese said...

Hello, I saw your postings and I wondered if anyone currently knows what ICD 9 codes are being accepted by inusrance for procedure codes 95810, 95811, and 95805? We are told 327.23 is the one insurances want to see to pay; however, we have some sleep doctors who are adamant about certain patients not having OSA and so I was wondering if anyone knew of any other codes that may be acceptable? Thank you so much.

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