Insurers use the International Classification of Diseases, Ninth Revision (ICD-9) diagnosis code to demonstrate medical necessity for services. When ordering an apnea monitor, for example, in addition to the clinical documentation in the medical record, the most specific diagnosis(s) codes must be provided to the insurer. For example, the ICD-9 diagnosis code series 770.8x is used to identify other respiratory problems after birth. This series of codes includes a variety of clinical conditions. ICD-9 code 770.8 is considered a base code and as such is incomplete. In order to accurately describe the reason the apnea monitor was ordered, it is critical to select and include the appropriate fourth and fifth digits of the ICD-9 code; not doing so may result in denial of the requested service. For example, if the reason for ordering the apnea monitor is newborn apnea, the appropriate diagnosis code would be 770.81. Most insurers have medical policies available on their Internet sites. Providers may look to these policies for specific details regarding covered diagnosis codes. Code 94774 is used for reimbursement for a full month of pediatric home apnea monitoring event recordings, including respiratory rate, pattern and heart rate, monitor attachment, download of data, physician review and interpretation, and preparation of a report. This code should not be used during the same reporting period as 94775-7. There are two codes used when home-care companies share the responsibility for monitor downloads such as monitor hook-up, initiation of recording, and disconnection (94775). There is a separate code for monitoring, download, and analyses by computer only (94776) used by home-care companies, as well as a code for physician review, interpretation, and preparation of report only (94777). Oxygen saturation (although it is not standard) is not coded separately when it is used along with an apnea monitor download. Again, it is important to note that diagnostic sleep studies (home or laboratory polysomnograms, or limited channel sleep studies) are not equivalent to apnea monitor downloads, and these are coded separately. Insurance carriers must be contacted regarding reimbursement because some companies will not authorize both apnea monitor downloads and “pneumogram” studies at the same time. Although individual insurance companies will provide reimbursement information, other helpful Web sites include those from major manufacturing companies that supply apnea monitors (http://reimbursement.respironics.com/). These Web sites (and the government relations directors for the company) often carry up to date billing, coding, and reimbursement information for the products they sell by state. It is best to be mindful of the state- to-state differences in reimbursement, as well as products that vary in availability depending on the country. For reimbursement problems, health-care providers should contact their regional Centers for Medicare and Medicaid Services office at http://www.cms.hhs.gov/ under “About CMS, Agency Information”. More coding information is available through the AAP Web site at http://www.aap.org/, where Coding for Pediatrics 2007, Twelfth Edition can be purchased through the AAP Bookstore. A short document of coding changes is available at http://www.aap.org/sections/pem/CodingUpdate.pdf.