Wiki what place of service code to use for in-house credentialed sleep lab?

[eutsler]

Te practice has a credentialed sleep lab in office, and they are performing monitored polysomnography. They are getting many denials for POS when 95810 & 95811 are submitted with POS 11.

The lab is not affiliated with a hospital, but it is under the direction and control of a physician. Is this a case of the POS being wrong, or should the AR department prepare standard documentation and be ready to file lots of appeals?

 

[cgaston]

Here is a list of the POS codes from Medicare: https://www.cms.gov/Medicare/Medica...anFeeSched/Downloads/Website-POS-database.pdf

I think what you describe closely resembles POS 49, but you should definitely contact your payers to find out if that is what they are looking for.