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Ask a Rev Cycle Expert: Unattended Sleep Study 95806 vs G0399?

Question:

Both CPT® codes 95806 and G0399 are accepted by Medicare for unattended home sleep study. Both codes are very similar, but what is the differentiating factor for these? Is it the use of the devices in the G code?

Answer:

Current Procedural Terminology (CPT®) code 95806 Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement) may be performed in an outpatient department or at the patient’s home. This code is to evaluate for a variety of disorders, including sleep apnea, narcolepsy, sleep walking, restless leg syndrome, etc. This service is covered in a sleep lab and is a prerequisite for the home sleep test. Healthcare Common Procedure Coding System (HCPCS) code G0399 Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation was created specifically to report home sleep testing for the specific Medicare benefit.

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