Medical Billing Forum

Coding => Coding => Topic started by: slacross on August 23, 2010, 02:19:07 PM

Title: Billing for sleep studies; CPT code 95810
Post by: slacross on August 23, 2010, 02:19:07 PM
I am new to billing Pulmonary/Sleep Clinic. The provider is billing for 95810. Is this code used just for
the physician, or is this a global code and I have to indicate a 26 modifier for the professional component
only? Thanks.
Title: Re: Billing for sleep studies; CPT code 95810
Post by: Michele on August 24, 2010, 09:19:01 PM
I found the following information:

Technical and Professional Components of Sleep Studies
Providers can bill for services in diagnostic sleep testing in one of three ways:
Owners of some freestanding centers will bill for their technical fee as 95810-TC; the -TC modifier indicates that the bill is for the technical component of service only.
Physicians interpreting diagnostic tests in hospital-based sleep centers or in some freestanding IDTF sleep centers, will bill using CPT 95810-26; the -26 modifier means the bill is for the professional work only.
Physicians providing services in their offices or in some freestanding sleep centers bill for the global service - both the professional work (interpretation) and the technical component - using the appropriate CPT code, such as 95810, without a modifier.