CPT® Code 0204T | Case2Code

Code deleted, see 95801.

Official Description

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

Common Language Description

The CPT® Code 0204T 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 demand for sleep studies and the backlog at traditional sleep study centers, as well as the fact that many patients may not reside near these facilities. Unlike comprehensive polysomnography performed in a sleep center, which records a wide array of physiological parameters, the unattended sleep study captured by this code focuses on a minimum set of vital metrics. Specifically, it records heart rate, oxygen saturation, and respiratory analysis, which can be assessed through either airflow measurement or peripheral arterial tone (PAT). The procedure employs portable devices that are designed to be user-friendly and efficient, allowing for the collection of essential data while the patient sleeps. Airflow can be monitored using two types of devices: one that utilizes a thermal sensor placed on the upper lip to detect changes in temperature associated with airflow, and another that employs a mask fitted over the nose and mouth to directly measure airflow. The combination of airflow data with heart rate and pulse oximetry readings enables healthcare providers to evaluate the presence and severity of respiratory disturbances during sleep. Additionally, the PAT method measures changes in arterial pulsatile volume in the finger, which reflects the activity of the sympathetic nervous system. This technique indirectly identifies apnea events by detecting surges in sympathetic activation that occur at the conclusion of an apnea episode. The data collected from these various measurements is analyzed by the portable device to calculate the PAT respiratory disturbance index (RDI), providing valuable insights into the patient's sleep patterns and potential sleep disorders. The setup of the portable device involves programming it to record the necessary parameters, attaching the appropriate sensors, and ensuring that the patient is comfortable for the duration of the study. This code is specifically used when sleep time is not measured, distinguishing it from other codes that may include sleep duration as part of the assessment.

1. Indications

The unattended sleep study represented by CPT® Code 0204T is indicated for patients who may exhibit symptoms or conditions suggestive of sleep-related disorders. These indications include, but are not limited to, the following:

Obstructive Sleep Apnea (OSA) Patients presenting with symptoms such as excessive daytime sleepiness, loud snoring, or observed apneas during sleep may require this study to evaluate for OSA.
Insomnia Individuals experiencing difficulty in falling or staying asleep may benefit from this assessment to rule out underlying sleep disorders.
Restless Legs Syndrome (RLS) Patients reporting uncomfortable sensations in the legs and an uncontrollable urge to move them, particularly during the evening or night, may be evaluated using this sleep study.
Chronic Fatigue Those suffering from unexplained chronic fatigue may undergo this study to determine if sleep disturbances are contributing to their condition.

2. Procedure

The procedure for conducting an unattended sleep study using CPT® Code 0204T involves several key steps to ensure accurate data collection and patient comfort. The process begins with the setup of the portable sleep study device, which is programmed to record the necessary parameters. The healthcare provider will select the appropriate method for measuring airflow, either by using a thermal sensor placed on the upper lip or by fitting a mask over the patient's nose and mouth. This choice depends on the specific device being utilized and the patient's comfort level.

Step 1: Device Setup The portable sleep study device is prepared and programmed to monitor heart rate, oxygen saturation, and respiratory analysis. This setup is crucial for ensuring that all necessary data points are captured during the patient's sleep.
Step 2: Sensor Attachment If airflow is to be measured, the provider will place a tight-fitting mask over the patient's mouth and nose or attach a thermal sensor to the upper lip. Additionally, a heart rate monitor and pulse oximetry device are affixed to the patient's finger to continuously track heart rate and oxygen levels throughout the night.
Step 3: PAT Measurement In cases where peripheral arterial tone is being measured, a specialized finger device that includes the PAT sensor, heart rate monitor, and oximetry device is attached to the patient's finger. This device will record changes in arterial pulsatile volume, which is indicative of sympathetic nervous system activity.
Step 4: Data Recording Once the patient is comfortably set up, the ambulatory system begins recording data as the patient sleeps. The device captures the necessary parameters throughout the night, allowing for a comprehensive analysis of the patient's sleep patterns and any potential disturbances.

3. Post-Procedure

After the completion of the unattended sleep study, the patient will typically remove the device and sensors. The recorded data will then be analyzed by a healthcare professional to assess the presence of any sleep disorders, such as obstructive sleep apnea or other respiratory disturbances. The results of the study will be compiled into a report, which will include the findings from the heart rate, oxygen saturation, and respiratory analysis. Follow-up appointments may be scheduled to discuss the results and determine any necessary treatment options based on the findings. It is important for patients to understand that the analysis of the data may take some time, and they should be informed about when to expect results and any subsequent steps in their care plan.

Short Descr	UNATTENDED SLEEP STUDY
Medium Descr	SLPSTD UNAT SIM REC HRTRT OXSAT RSP ALYS
Long Descr	Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone)
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)	none
MUE	Not applicable/unspecified.
CCS Clinical Classification	227 - Other diagnostic procedures (interview, evaluation, consultation)