CPT® Code 0203T | Case2Code

Code deleted, see 95800.

Official Description

Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone) and sleep time

Common Language Description

The CPT® Code 0203T refers to an unattended sleep study that is conducted using a portable sleep study system, typically in the patient's home or another ambulatory setting. This type of sleep study is increasingly utilized due to the growing backlog at traditional sleep study centers and the geographical challenges faced by many patients who do not reside near these facilities. Unlike comprehensive polysomnography performed in a sleep center, which records a wide array of physiological parameters, the portable systems associated with this code are designed to capture fewer parameters. Specifically, they monitor heart rate, oxygen saturation, and respiratory analysis, which can be assessed through methods such as airflow measurement or peripheral arterial tone (PAT). The unattended nature of this study allows for greater flexibility and convenience for patients, as they can undergo the evaluation in a familiar environment. The procedure involves the use of various devices to measure airflow, heart rate, and oxygen levels. Airflow can be monitored using two types of devices: one that employs a thermal sensor placed on the upper lip and another that utilizes a mask covering the nose and mouth. These devices work in conjunction with heart rate and pulse oximetry data to assess any respiratory disturbances that may occur during sleep. Additionally, PAT technology measures changes in arterial pulsatile volume in the finger, which reflects sympathetic nervous system activity. This method indirectly detects apnea events by identifying surges in sympathetic activation that occur at the end of an apnea episode. The data collected from these measurements is analyzed by the portable device to calculate the PAT respiratory disturbance index (RDI). The setup of the portable device is straightforward, involving the placement of a mask or thermal sensor, attachment of heart rate and oximetry monitors, and programming the device to record data throughout the patient's sleep period. It is important to note that CPT® Code 0203T should be used when sleep time is measured, while CPT® Code 0204T is applicable when sleep time is not recorded.

1. Indications

The unattended sleep study represented by CPT® Code 0203T is indicated for patients who exhibit symptoms or conditions suggestive of sleep-related disorders. These may include:

Obstructive Sleep Apnea (OSA) Patients presenting with symptoms such as loud snoring, episodes of breathing cessation during sleep, excessive daytime sleepiness, or difficulty concentrating may be evaluated for OSA.
Insomnia Individuals experiencing chronic difficulty in falling or staying asleep may require assessment to determine underlying sleep disturbances.
Restless Legs Syndrome (RLS) Patients reporting uncomfortable sensations in the legs and an uncontrollable urge to move them, particularly during periods of rest, may benefit from a sleep study.
Periodic Limb Movement Disorder (PLMD) Those who experience involuntary leg movements during sleep that disrupt their sleep patterns may be candidates for this type of study.

2. Procedure

The procedure for conducting an unattended sleep study using CPT® Code 0203T involves several key steps:

Device Setup The portable sleep study device is set up and programmed to record the necessary parameters. This includes ensuring that all sensors and monitors are functioning correctly and are ready for use during the patient's sleep.
Airflow Measurement If airflow is to be measured, a tight-fitting mask is placed over the patient's mouth and nose, or a thermal sensor is positioned on the upper lip. This setup is crucial for accurately assessing respiratory patterns during sleep.
Heart Rate and Oximetry Monitoring A heart rate monitor and pulse oximetry device are attached to the patient's finger. These devices will continuously record heart rate and oxygen saturation levels throughout the night.
PAT Measurement If PAT is included in the study, a specialized finger device that incorporates the PAT technology, along with heart rate and oximetry monitoring, is affixed to the patient's finger. This device will track arterial pulsatile volume changes, providing additional data on sympathetic nervous system activity.
Data Recording Once the patient is prepared, the ambulatory system records data as the patient sleeps. The device captures information on heart rate, oxygen saturation, and respiratory analysis, which will later be analyzed to assess any sleep disturbances.

3. Post-Procedure

After the completion of the unattended sleep study, the patient will typically be instructed to return the portable device to the healthcare provider for data analysis. The recorded data will be evaluated to determine the presence and severity of any sleep-related disorders. Patients may receive follow-up instructions based on the findings, which could include recommendations for further testing, lifestyle modifications, or treatment options. It is essential for healthcare providers to review the results with the patient to discuss any necessary next steps in managing their sleep health.

Short Descr	UNATTEND SLEEP STUDY W/TIME
Medium Descr	SLPSTD UNAT SIM REC HRTRT OXSAT RSP ALYS&SLP TM
Long Descr	Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone) and sleep time
Status Code	Carriers Price the Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
Type of Service (TOS)	1 - Medical Care
Berenson-Eggers TOS (BETOS)	M5D - Specialist - other
MUE	Not applicable/unspecified.
CCS Clinical Classification	227 - Other diagnostic procedures (interview, evaluation, consultation)