Medicare is establishing the following coverage for CPT/HCPCs 95807, 95808, 95810:
Attended Studies
** CPT Codes: 95807, 95808, 95810, 95811, 95782, 95783. Unattended Study
** CPT Code: 95806 (Note that this CPT code is identical to 95807 except that the study is not monitored.) 95800, 95801 (These differ from 95806 in the description of a single respiratory sensor [either air flow or peripheral arterial tone] instead of the standard configuration of both respiratory effort and respiratory airflow [ventilation]).
** Use of overnight oximetry alone would be indicated by CPT code 94762. HCPCS Codes
** There is 1 HCPCS code identifying a CPAP device, E0601, and 2 HCPCS codes for BiPAP devices: E0470 and E0471. The HCPCS codes do not distinguish among fixed CPAP or BiPAP devices and auto-adjusting CPAP devices.
Covered for ICD-9-CM indications:
| 278.01 | MORBID OBESITY |
| 307.41 – 307.48 | TRANSIENT DISORDER OF INITIATING OR MAINTAINING SLEEP – REPETITIVE INTRUSIONS OF SLEEP |
| 327.10 – 327.15 | ORGANIC HYPERSOMNIA, UNSPECIFIED – HYPERSOMNIA DUE TO MENTAL DISORDER |
| 327.19 | OTHER ORGANIC HYPERSOMNIA |
| 327.20 – 327.27 | ORGANIC SLEEP APNEA, UNSPECIFIED – CENTRAL SLEEP APNEA IN CONDITIONS CLASSIFIED ELSEWHERE |
| 327.29 | OTHER ORGANIC SLEEP APNEA |
| 327.30 – 327.37 | CIRCADIAN RHYTHM SLEEP DISORDER, UNSPECIFIED – CIRCADIAN RHYTHM SLEEP DISORDER IN CONDITIONS CLASSIFIED ELSEWHERE |
| 327.40 – 327.42 | ORGANIC PARASOMNIA, UNSPECIFIED – REM SLEEP BEHAVIOR DISORDER |
| 327.44 | PARASOMNIA IN CONDITIONS CLASSIFIED ELSEWHERE |
| 327.51 – 327.53 | PERIODIC LIMB MOVEMENT DISORDER – SLEEP RELATED BRUXISM |
| 333.2 | MYOCLONUS |
| 347.00 – 347.01 | NARCOLEPSY, WITHOUT CATAPLEXY – NARCOLEPSY, WITH CATAPLEXY |
| 347.10 – 347.11 | NARCOLEPSY IN CONDITIONS CLASSIFIED ELSEWHERE, WITHOUT CATAPLEXY – NARCOLEPSY IN CONDITIONS CLASSIFIED ELSEWHERE, WITH CATAPLEXY |
| 518.83 | CHRONIC RESPIRATORY FAILURE |
| 780.50 – 780.51 | UNSPECIFIED SLEEP DISTURBANCE – INSOMNIA WITH SLEEP APNEA, UNSPECIFIED |
| 780.53 – 780.58 | HYPERSOMNIA WITH SLEEP APNEA, UNSPECIFIED – SLEEP RELATED MOVEMENT DISORDER, UNSPECIFIED |
| 786.04 | CHEYNE-STOKES RESPIRATION |
