The Office of Inspector General for the U.S. Dept. of Health and Human Services has identified diagnostic sleep-testing procedures as a target in its 2016 Work Plan. The OIG will "assess the appropriateness of Medicare payments for high-use sleep-testing procedures and determine whether they were in accordance with Medicare requirements."
In order for your facility to comply with coding and billing guidelines for sleeps studies, you must insist on receiving complete and comprehensive documentation from your own physicians as well as sleep disorder clinics.
In this webcast you will be learn how to identify information from sleep study providers that pose utilization and billing risks for being non-compliant.
From this webcast you will...
- Learn the requirements for a valid sleep study order
- Know what constitutes a covered diagnosis based on local coverage determinations (LCDs) and payer guidelines
- Learn guidance for the proper sequencing of diagnosis codes on claims
- Understand the required documentation to support medical necessity for testing
- Know why an Advance Beneficiary Notice is required for a sleep study