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Correction: Polysomnography – Place of Service Code Added and Local Codes Terminated

August 3, 2016

This article updates information published in the July 2016 Medi-Cal Update. The effective date for the addition of Place of Service code “7” is updated to September 1, 2013. The effective date for the terminated HCPCS Level III local codes is updated to August 1, 2016. The previous article is corrected below.

Effective retroactively for dates of service on or after September 1, 2013, Place of Service code “7” (other) is added to the list of available Place of Service codes when billing for the following polysomnography CPT-4 codes:

CPT-4
Code
Description
95782 Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
95783   younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist
95810   age 6 or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
95811   age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist

An Erroneous Payment Correction (EPC) will be processed to reimburse claims for the CPT-4 codes listed above denied for Place of Service code “7” for dates of service on or after September 1, 2013.

Also, effective for dates of service on or after August 1, 2016, the following HCPCS Level III local codes used to reimburse sleep study services are terminated:

Local
Code
Description
Z0306 Polysomnography; analysis, interpretation and report without recording
Z0314 Transport equipment to home
Z0318 Directly observed therapy
Z7600 Polysomnography, sleep evaluation, simple
Z7602 Polysomnography, sleep evaluation, complex