AMA CPT® Assistant - 2013 Issue 2 (February)
Coding Brief: Polysomnography Changes for 2013 (February 2013)
February 2013 pages 14-15 Coding Brief: Polysomnography Changes for 2013 Sleep medicine services include procedures that evaluate adult and pediatric patients for a variety of sleep disorders. Sleep medicine testing services are diagnostic procedures, using in-laboratory and portable technologies to assess physiologic data and therapy. The Sleep Medicine Testing subsection in the CPT 2013 code set has been revised. Specifically, two new codes for pediatric testing were added and three of the existing subsection codes were modified to specify age groups. This coding brief will discuss the revisions of the Sleep Medicine Testing subsection and describe the rationale for...
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Article Overview
This coding brief explains the 2013 updates to CPT sleep medicine testing, focusing on how polysomnography reporting changed for adult and pediatric patients. It is intended for coders, sleep medicine staff, and billing professionals who need a general understanding of the revised subsection structure, age-based service categories, and reduced-services reporting guidance. The article also covers the rationale for the changes, related terminology, and guidance on reporting when testing time is reduced.
Why This Topic Matters
Sleep study coding changed in CPT 2013, including new pediatric reporting options and revised age-based code structure. Understanding the scope of the update helps practices align documentation, reporting, and claim submission with the revised sleep medicine testing subsection.
Article Sections
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February 2013 pages 14-15
Publication context for the coding brief.
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Rationale for New and Revised Codes
Background on why the sleep medicine testing subsection was updated and the broad clinical factors underlying the revision.
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CODING TIP
A brief note about where the new pediatric entries appear in the CPT 2013 code set.
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Definitions
Key terminology used in the sleep medicine testing subsection, including attended testing and polysomnography.
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Revised Polysomnography Guidelines
General reporting guidance for sleep studies, including reduced-services reporting and time-based considerations.
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Adult Polysomnography
Overview of reporting categories for adult sleep studies under the revised CPT structure.
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CODING TIP
A note on reduced-services reporting for selected sleep study codes when recording time is limited.
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Pediatric Polysomnography
Overview of reporting categories for pediatric sleep studies under the revised CPT structure.
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CODING TIP
A note on reduced-services reporting for pediatric sleep study codes when recording time is limited.
What You Will Learn
- How the CPT 2013 sleep medicine testing subsection was revised
- How the article distinguishes pediatric and adult polysomnography reporting
- What general kinds of guidance are included for reduced-services reporting
- What terminology is defined for sleep testing documentation and review
Who Should Read This
- Medical coders
- Sleep medicine billing staff
- Clinical documentation staff
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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