Wiki 95800

[londam]

I work for an ENT practice that is looking to start home sleep studies. The CPT code the practice will be using is 95800. Does this code typically require prior authorization for commercial insurances.

 

[CBLENNIE]

In my experience working for a commercial insurance company require PA for not only sleep testing but sleep treatment. It looks like BCBS of NC does require it based on this webiste link. https://www.bluecrossnc.com/providers/prior-authorization/services-requiring-ppa. You should check each of the major insurance carriers that you work with to determine what each carrier's PA requirements are for sleep testing and sleep therapy.

 

[londam]

In my experience working for a commercial insurance company require PA for not only sleep testing but sleep treatment. It looks like BCBS of NC does require it based on this webiste link. https://www.bluecrossnc.com/providers/prior-authorization/services-requiring-ppa. You should check each of the major insurance carriers that you work with to determine what each carrier's PA requirements are for sleep testing and sleep therapy.

Thank you so much. I am in the process of checking each one. I am new at this so, I thought it would be a good idea to reach out to others in this specialty to help me get started. Thanks so much for replying back.