Resources
This is the sleep clinical specialist.
Who is Lauren Jones.
This guideline is used to review initial sleep studies.
What is SL-2.1?
A split night study is requested as this CPT code.
What is CPT95811.
This is the name of the application that houses the EviCore templates for documentation.
What is EviNotes?
You receive a case for in-lab study, 95810, for pediatric patient age 4. What is the best action for this case?
What is redirect to CPT 95782
This is the Sharepoint site that includes all specialty educations and resources.
What is the Specialty Resource Center or SRC?
This guideline is used to review repeat sleep studies.
What is SL-2.6?
HSAT is requested as any one of these CPT codes. (Hint: There are 6)
What are:
G0398
G0399
G0400
95800
95801
95806
Using this acronym will populate the Sleep CR Template in EviNotes.
What is sltem?
You receive a call on a case for initial E0601. The caller provides verbal clinical including the prior study with AHI 8. The patient has been instructed by the DME company regarding the PAP and there is a compliance support plan between the DME and MDO. What is the best action for this case?
What is Approve?
This resource is used to find specific health plan information such as CPT code list and appropriate numbers.
What is the Nurse Job Aid?
This guideline is used for CPAP in pediatrics.
What is SL-3.2?
Diagnostic sleep testing is requested as this CPT code.
What is CPT95782.
True or False: In CDP, you may remove sections of the templates that do not apply to your case.
What is False?
The request is for replacement E0601. The device is over 5 years old, but functions properly. There are no sleep complaints with CPAP. What is the best action for this case?
What is Send to MD Review?
This resource is used to find general case-processing questions.
What is the Clinical Education Guide or CEG?
This number is the BMI considered as a co-morbid condition.
What is greater than or equal to 45?
These are the two codes required for MSLT requests.
What are CPT95810 and CPT95805?
These two things should always be documented when taking verbal clinicals.
What is the caller's first and last name AND their location?
The request is for 95811, repeat titration. The patient is complaining of snoring and EDS despite CPAP. Current compliance report shows 13/30 night with avg usage 5 hours per night. What is the best action for this case?
What is Send to MD review.
This is where sleep educations are housed.
What is the Sleep Education Guide?
Replacement Bi-PAP is found in this guideline.
What is SL-4.2.3
This HCPC code is used to order ASV.
What is HCPC E0471?
This is one thing that should never be documented in the journal/pathway of a case.
What is internal process?
The request is for E0601 continued rental. Compliance is provided - 30/30 days with avg use of 8 hours 39 minutes per night. What is the best action for this case?
What is Forward to STS.