Wiki 95816 Denial

[mjlan_72@yahoo.com]

I am stumped on this one. Doc did an EEG awake and 95816 was billed. Insurance is denying stating medical records submitted include that EEG was performed. However, the records didn't include recording in awake and drowsy state. I can’t find an EEG code for alert only. Any suggestions/ appeal examples?

Here is an example of the report:



Thank you for any help!
Mary Jo

 

[mjlan_72@yahoo.com]

Does anyone have any suggestions? I am still getting denials on this.