For patients/drivers who fail sleep apnea screening and are given info to get sleep apnea study . how should we charge them when they return for follow up within the 60 day time period?

This is marked on a DOT examination form as a follow up.  A new exam is not needed but we have to update interim history, review the sleep test report and sleep specialist recommendations, determine if treatment for sleep apnea is required and are they adequately treated (PAP 4h/ night 70% of nights for at least one week).

Then issue a 90 day certification if under treatment, or one year from the original DOT exam if sleep apnea treatment is not required.  (We have a DOT exam recheck charge for this, the fee has usually been equivalent to a 99212).  On the 90 day visit, this is now a DOT recertification, not a follow up, so a full exam is completed just as for any recertification.  If sleep apnea treatment is satisfactory and compliant (4h/night, 70% of nights for the 90 days), a one year certification from that date is given.  If noncompliant, disqualify until compliant, then examiner discretion on successive certification intervals.

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