DecisionHealth, DecisionHealth - 2016 Issue 11 (November)

Stay alert for home sleep study payer policies that vary from CPT

Question: We have a provider who is billing for home sleep studies with 95800. However, CGS Administrators is denying the service with claims adjustment reason code CO-5 (The procedure code/bill type is inconsistent with the place of service). Can you tell us why we’re getting this denial?

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