Recently, four Medicare Part B Contractors – National Government Services, Palmetto, Highmark, and Wisconsin Physicians Service – revised local coverage determination (LCD) policies for sleep studies. Find the LCD policy for your region by searching the Medicare database using the instructions on the Coding and Compliance section of the AASM website.
To date, LCD policies for sleep studies for Medicare Part B Contractors Noridian, Trailblazer and First Coast have not been revised. These policies were last revised in late 2010. According to these published LCD policies, Noridian, Trailblazer and First Coast are not paying for the new sleep medicine CPT codes 95800 and 95801 at this time.