Palmetto GBA recently published a draft version of its local coverage determination (LCD) Polysomnography and Sleep Studies for Testing Sleep and Respiratory Disorders (L28292): www.cms.hhs.gov/mcd/viewlcd.asp?lcd_id=28292&lcd_version=5&show=all.
The primary geographic jurisdiction for Part B claims is Jurisdiction 1 (J1) which includes the following states: California, Hawaii, and Nevada.
According to the LCD, "The polysomnography must be performed in a facility-based sleep study laboratory, and not in the home or in a mobile facility."
The 45-day comment period for the LCD commenced June 16, 2008. The LCD is effective September 2, 2008.
Dr. Mary Susan Esther, president of the American Academy of Sleep Medicine, and other representatives from the Board of Directors have worked with Palmetto on development of this and other LCD policies.
A current list of available Medicare LCD policies is on the AASM Web site: https://aasm.org/clinical-resources/coding-reimbursement/medicare-policies/. Dr. Esther is committed to ensuring LCD policies are in-line with the AASM’s guidelines for portable monitoring, and has made this a priority for her tenure.
