AHA Coding Clinic® for HCPCS - 2017 Issue 4; Ask the Editor

Home Automatic Positive Airway Pressure (APAP)

A patient was seen in our sleep lab for sleep study, which resulted in a diagnosis of sleep apnea and an order for a home Automatic Positive Airway Pressure (APAP) Titration Study in order to determine the appropriate CPAP pressure. The patient returned to the sleep lab and an APAP machine was provided with instructions for home use. Five days later, they brought the APAP machine back as instructed. Data was downloaded from the APAP machine and the physician documented an interpretation and subsequently ordered a home CPAP machine from our durable medical equipment (DME) provider to be set at the established pressure and delivered to the patient for ongoing home CPAP therapy.  What CPT/HCPCS code(s) should the sleep lab use for the home APAP Titration Study? Many of our coders feel that CPT 94660, Continuous positive airway pressure ventilation (cap), initiation and management, is the most appropriate code as this study is an inherent part of initiating CPAP therapy. However, some of our coders feel that 94660 is not appropriate and recommend reporting this work with a facility E/M code.  ...

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