Our sleep clinic manager wants to create a checklist to decrease Medicare denials for polysomnography (PSG) codes 95810 and 95811. Can you provide a few examples of reasons for denial that we can include on our list?
The following common reasons for PSG denials are a good place to start to improve clinical and administrative practices.
- Inappropriate diagnosis codes
- Unbundling a split-night service
- Double-billing for the professional component
- Repeated titrations
- Titration with no corresponding treatment device
- Missing visit with ordering provider
- Repeated PSG services