Wiki Split-Night downcoding

Messages
6
Location
Glendale, AZ
Best answers
0
Hello,

Is anyone experiencing issues with sleep medicine billing when a split-night study (95811) is ordered but does not meet split-night criteria? Many insurance companies are denying these claims and refusing to allow a downcode to a diagnostic study (95810).

How are billers addressing this issue? Any insights or successful appeal strategies would be greatly appreciated.
 
Top