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Guest
#1 Posted : Wednesday, December 21, 2016 1:24:25 PM(UTC)
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We use home pulse oximetry for patients that are suspected of possible sleep apnea issue. What diagnosis code should be used when billing medical for 94762?
courtneydsnow
#2 Posted : Thursday, December 22, 2016 8:22:30 AM(UTC)
courtneydsnow

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Hi guest!

The diagnosis code will depend on the patient! Here are some examples of some ICD-10 coding options that may apply to patients with suspected sleep disordered breathing:

R06.83 - Snoring
R53.83 - Other fatigue


However, just a heads up, some medical insurers may not offer coverage for overnight pulse oximetry for screening for OSA/sleep disordered breathing. For example, here is a link to Aetna's medical policy titled "Pulse Oximetry for Home Use"
http://www.aetna.com/cpb/medical/data/300_399/0339.html

In the policy, it states:
"Aetna considers the use of home pulse oximetry experimental and investigational for all other indications, including the following because its effectiveness for these indications has not been established:

Asthma management
Diagnosing nocturnal hypoventilation associated with neuromuscular disorders
Evaluating and teaching continuous positive airway pressure (CPAP)
Maintenance or continuous monitoring (other than for persons on a ventilator)
When used alone as a screening/testing technique for suspected obstructive sleep apnea."

Hope this helps, have a great day!

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