Polysomnography and Sleep Testing
L33405
Polysomnography (Type I–IV) and approved home sleep tests are covered primarily to diagnose obstructive sleep apnea (OSA) in beneficiaries with clinical signs and symptoms, with device-type coverage tied to the number of physiologic channels recorded and whether testing is attended or unattended. Narcolepsy evaluation requires PSG followed by MSLT (4–5 nap protocol), and PSG is indicated for select other disorders (neuromuscular-related sleep symptoms, parasomnias with seizure/violent features, periodic limb movement disorder) while HST is specifically excluded for narcolepsy, certain respiratory and neuromuscular comorbidities, and other non-OSA indications; documentation requirements include a prior face-to-face evaluation (sleep history, Epworth score, BMI/neck circumference) and interpretation by credentialed physicians and certified technologists.
"Type I polysomnography (PSG) is covered to aid diagnosis of obstructive sleep apnea (OSA) when clinical signs/symptoms indicative of OSA are present and the study is performed attended in a sleep l..."