2025 HCPCS code G0400
(Active) Effective Date: N/A Revision Date: N/A Diagnostic Testing - Sleep Studies E Feed
Home sleep test (HST) using a Type IV portable monitor, unattended, with a minimum of three channels.
Modifiers may be applicable depending on the specific circumstances of service delivery. Consult current modifier guidelines for appropriate use.
Medical necessity for a G0400 home sleep test is established when a patient presents with clinical symptoms or findings suggestive of a sleep disorder that requires objective assessment through polysomnography.This may include, but is not limited to, OSA, narcolepsy, parasomnias, and PLMD. Documentation must support the clinical indication for the test.
A physician or other qualified healthcare professional orders and interprets the results of the home sleep test.The test itself may be administered by trained personnel or the patient, depending on the specific device and instructions.
In simple words: This code covers a sleep study done at home using a small, portable device that monitors your body functions while you sleep.It's unattended, meaning you don't need a technician present, and helps diagnose sleep problems.
This HCPCS code, G0400, represents a home sleep test (HST) performed using a Type IV portable monitor that is unattended.The test requires a minimum of three channels to record physiological parameters during sleep.The recorded data is subsequently analyzed to diagnose sleep disorders such as obstructive sleep apnea, narcolepsy, parasomnias, or periodic limb movement disorder. The test is conducted overnight in the patient's home.
Example 1: A patient presents with symptoms suggestive of obstructive sleep apnea (OSA). The physician orders a G0400 home sleep test to obtain overnight physiological data for diagnosis and to guide treatment decisions., A patient reports excessive daytime sleepiness and possible narcolepsy.The physician uses code G0400 to order a home sleep test to evaluate sleep architecture and identify potential sleep disorders., A patient experiences periodic leg movements during sleep, impacting sleep quality. A G0400 home sleep test is used to objectively assess the frequency and severity of periodic limb movement disorder (PLMD).
Physician's order specifying the need for a home sleep test.Patient demographics and medical history.Detailed report of the sleep study results including relevant physiological parameters (e.g., EEG, EMG, ECG, respiratory effort, oxygen saturation).Physician's interpretation and diagnosis based on the study results.
** The specific type IV portable monitor used should be documented.Ensure that the number of channels used meets the minimum requirement of three.The interpretation of the test results should be performed by a qualified healthcare professional.
- Payment Status: Active
- Modifier TC rule: The TC modifier (Technical Component) is generally not applicable to this code as it represents a comprehensive diagnostic service.
- Specialties:Sleep Medicine, Pulmonary Medicine, Neurology
- Place of Service:Home