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Q: Our LCD recently dropped the diagnosis code for complex sleep apnea and central sleep apnea (327.21 and 327.27). What would you recommend to best treat this patient population?
A: I presume you're referring to coverage for sleep studies. The national policy, which became effective last year, covers sleep studies for OSA (327.23) and related disorders. Some MACs have taken this to literally mean coverage is only for OSA. I'd suggest you contact the American Academy of Sleep Medicine (www.aasm.org) to see if they have any suggestions to get your Medicare MAC to be more liberal in their interpretation.
Ray Cathey, PA-C, MHA, FAHC, CHCC, is the president/owner of Medical Management Dimensions in Stockton, Calif.
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Reimbursement rates and CPT codes are subject to change based on region and updates to regulations. ADVANCE's Coding Q&A column is a guide only - check the specific coverage in your area to ensure accuracy.
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