Amanda Posted 1 Year(s) ago
My doc does the interpretation for sleep studies done at a couple of hospitals. We do not have any contact with the patients before their tests, he just does the reading part. I have been billing 95806 w/26 modifier and have had no problems until Indiana Anthem Medicaid/HIP recently started denying them for lack of a PA. The hospital will give me the PA# and but Anthem says the PA is only for G0399 and not 95806 but the hospital says they aren't given the option of doing a PA for the 95806. Based on what I have read, it doesn't seem appropriate for us to the G0399 as we are not instructing the patients or giving them the devices, we are strictly reading the results. I would appreciate any help!!
SuperCoder Posted 1 Year(s) ago
1 Year(s). There are 2 posts.
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is from SuperCoder