Dental Appliance Titration Studies

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Dental Appliance Titration Studies

Postby burchab1 » Tue Apr 22, 2014 4:39 pm

We just performed our first sleep study using an oral appliance. We were told that we should bill this as a 95811 because we were monitoring and titrating using the device. Is anyone out there doing these? How do you bill this study? Thanks
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Postby Vix » Tue Apr 22, 2014 5:00 pm

We are doing them too. You can NOT use 95811 because 95811 requires titration of PAP, specifically. You are not titrating PAP. You can bill them as 95810 - that's what we are billing them under.
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Postby cymri » Thu Apr 24, 2014 4:35 pm

Vix is correct
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Postby burchab1 » Wed Apr 30, 2014 6:16 pm

Actually just checked with ResMed's oral appliance division and they said that it does in fact get billed as a 95811.
The dentist that is helping the practice here in my area also has offices in Colorado, Idaho and Alaska and does a pretty fair amount of consulting also said that it is billed as a 95811.
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Postby tiredjohnny1 » Wed Apr 30, 2014 7:56 pm

Are you doing PAP titration while the patient's wearing the oral appliance?...in that case 95811 is appropriate. If you are doing basic diagnostic PSG while adjusting the patient's oral appliance (without PAP) then 95811 is not appropriate.

95810 and 95811 both cover polysomnography...but the sole difference between the two codes is initiation of PAP therapy. So 95811 applies solely to PAP. If PAP is not used, then 95810 applies. Reading the CPT code description should make this clear.
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Postby Vix » Wed Apr 30, 2014 7:58 pm

The definition of 95811 is "POLYSOMNOGRAPHY; SLEEP STAGING WITH 4 OR MORE ADDITIONAL PARAMETERS OF SLEEP, WITH INITIATION OF CONTINUOUS POSITIVE AIRWAY PRESSURE THERAPY OR BILEVEL VENTILATION, ATTENDED BY A TECHNOLOGIST".

How can you bill as 95811 without initiating CPAP or Bilevel?
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Postby somnonaut » Thu May 01, 2014 12:29 am

Where is it...I know I put the OIG's phone number here somewhere.
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Postby somnus diabolus » Sat May 31, 2014 11:42 pm

If they have been doing 95811, I agree that it is incorrect.
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Re: Dental Appliance Titration Studies

Postby somnonaut » Mon Nov 10, 2014 6:00 pm

Huh?
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Re: Dental Appliance Titration Studies

Postby Vix » Tue Nov 11, 2014 11:30 pm

A search shows that this Adrianna John has spammed other unrelated message boards with the same query.
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Re: Dental Appliance Titration Studies

Postby Dentalequips » Wed Feb 04, 2015 7:50 am

A search shows that this Adrianna John has spammed other unrelated message boards with the same query.

Yes. You are right
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Re: Dental Appliance Titration Studies

Postby simmondsdental » Tue Dec 06, 2016 7:40 am

Is this correct or not? I am still confused with number.
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Re: Dental Appliance Titration Studies

Postby Vix » Wed Dec 07, 2016 9:22 pm

You have to use 95810. You can not use 95811 because there is no titration of PAP during the study. Cut and dry.
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