Publisher's Synopsis
What you need to know to get paid Many respiratory therapy departments and hospital-based sleep centers do not understand how all the reimbursement pieces for outpatient sleep studies fit together especially the rules pertaining to medical necessity. This MedLearn Publishing book walks you through the intricacies of coding and compliance, helping you arrive at the full appropriate reimbursement. Highlights: * Comprehensive list of ICD-9 sleep-related diagnosis codes, along with tips for their proper application; includes a crosswalk to applicable ICD-10 codes * Explanation of Medicare national coverage policies for sleep disorders * How to interpret the official guidelines for achieving consistently accurate CPT code assignments, proper modifier usage and clean bills * The information required to support medical necessity, along with tips for avoiding other issues which can lead to payment denial * Advance beneficiary notice (ABN) key requirements and usage guidelines * How your revenue may be affected by coverage of home sleep testing * Special section for each CPT code assignable for sleep-related services, including indications for use, billing tips, CCI edit tables and 2013 APC payment tables * Summary of the most recent Office of the Inspector General (OIG) advisory opinions pertaining to sleep studies and the contractual relationship between sleep study providers and hospitals
