Wake Up to This New Reimbursement Opportunities for Obstructive Sleep Apnea (OSA)

Posted on 13. Sep, 2009 by .

Unblock $950 for genioglossus advancement with these coding & billing tips.

Coders have dealt with denials of treatments for obstructive sleep apnea for years, but proper coding should make now make genioglossus advancement —a radical OSA treatment — reimbursable.

Recently, the American Academy of Otolaryngology — Head and Neck Surgery sent letters to Wisconsin Physician Services and Anthem Blue Cross regarding their coverage policies for mandibular segmental osteotomy with genioglossus advancement (21199, Osteotomy, mandible, segmental; with genioglossus advancement) when performed to treat obstructive sleep apnea (OSA).

AUDIO CODING EDUCATION EVENT FOR OTOLARYNGOLOGY CODERS: 5 Tactics that get you paid for endoscopic sinus surgery.

Serious Condition, Radical Treatment

Obstructive sleep apnea (327.23, Organic sleep apnea; obstructive sleep apnea [adult] [pediatric]) describes a blockage of the upper airway that causes the patient to be unable to breathe. One of the ways an ENT can alleviate this potentially life-threatening condition is with genioglossus advancement.

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Sleep Study Reimbursement: How to Claim Your Piece of the Pie

Posted on 29. Apr, 2009 by .

Medicare promises to cover facility and home-based testing — as long as you meet these criteria.

Thanks to the green light CMS gave sleep testing in March, you may have an easier time receiving reimbursement for sleep studies–provided you meet certain guidelines for the types of patients you test and the equipment you use. Here’s what’s on your plate.

Which will bring in more reimbursement for your practice? Home sleep studies or lab studies. Jill Young answers all your C-PAP questions.

New: CMS announced March 3 that it will cover specified sleep tests that pulmonologists use to confirm the diagnosis in patients who have clinical signs and symptoms of obstructive sleep apnea (327.23). The agency will cover tests your pulmonologist conducts in a sleep laboratory facility in addition to many types of home sleep testing.

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