Medical billing is not easy. Frequent coding updates and billing rules make it harder. To ensure smooth billing, you must stay updated on new codes and regulations. These updates help with timely payments and Medicare compliance. Also, you must keep up with the latest updates to avoid billing errors and denials, thus improving your overall fiscal revenue drastically. It is important to remember that a good billing mechanism creates a perfect experience for both you and your patients. Here are some key updates you should know to ensure a perfect sleep study billing service— 

4 vital updates in your sleep study billing process that you must be aware of:  

Billing codes change all the time. Every year, CMS updates billing codes to match new treatments and technology. Some codes even get revised again. In fact, these below four updates will make billing easier, reduce confusion, and help you get the maximum reimbursement. 

1. Updated codes for Home Sleep Apnea Testing (HSAT):  

New billing codes for home sleep apnea testing are here. You should start using them now. Many patients prefer home-based sleep studies, so new codes help document different types of tests. Earlier, one code covered all HSATs. Now, you must use separate codes based on the device, number of sensors, and software interpretation. The new codes include:   

• • 95800 – Home sleep test with a minimum of four parameters   
• • 95801 – Home sleep test with three parameters   
• • G0398, G0399, G0400 –You need to assign these codes for documenting Medicare-approved home sleep studies. 

These updates make the sleep study billing service clearer and help ensure accurate payments for your sleep study lab. Your team must follow them carefully. Even a small mistake can lead to claim denials and cash flow issues. 

2. The new set of codes for polysomnography:  

Polysomnography (PSG) billing codes have also been updated, and you need to know them. The AMA has clarified codes to define monitoring duration and test complexity. These changes make billing more accurate and reduce claim denials.   

Here are some updated PSG codes:   

• • 95782 – Full-night PSG for patients under six years old   
• • 95783 – PSG with CPAP for patients under six years old   
• • 95810 – Full-night PSG for patients six years and older   
• • 95811 – PSG with CPAP for patients six years and older   

3. Newly changed codes for pediatric sleep studies:  

New billing codes for pediatric sleep studies are now in place. It is really important for you to stay on top of these updates as it is one of the ways your practice can ensure a perfect billing service for your younger patients.  
Thus, it is important to know that 95810 is for pediatric polysomnography and 95811 should be assigned for pediatric home sleep apnea testing. 

4. Clear guidelines for split-night study:  

There are new guidelines for split-night sleep studies. You can now have specific codes for each phase.   

A split-night study has two parts:   

1. 1. Diagnostic phase – Identifies sleep apnea (95810)   
2. 2. CPAP titration – Adjusts CPAP settings if apnea is found (95811)   

Use the correct codes to get full reimbursement. Make sure your billing team applies both codes properly. 

Medical billing is complex. It involves different codes for procedures, diagnoses, and measurements. Sleep clinics must follow insurance rules, work with providers, and coordinate with patients and insurers to get it all right. Billing mistakes can cause extra costs, claim denials, and lower payments. 

To avoid all the hassles of billing, claim denials, and revenue loss, most somnologists, these days, prefer to hire a perfect sleep study billing company to handle their end-to-end revenue cycle management. A perfect billing company knows what it takes to ensure maximized claims submission, excellent cash flow, and an awesome boost to your revenue.  

So, enjoy the best financial outcomes with peace of mind with a sleep study billing practice.