Change in Sleep Study and Wound Care Prior Authorization Requirements
Effective July 15, 2024, the following codes related to sleep study and wound care services will require prior authorization:
Code | Code Description | Pre-authorization |
95811 | POLYSOM 6/>YRS CPAP 4/> PARM | Pre-authorization required for all providers. |
11042 | DEB SUBQ TISSUE 20 SQ CM/< | Pre-authorization required for all providers after the first 12 visits. |
95782 | POLYSOM <6 YRS 4/> PARAMTRS | PA Required for all providers |
95783 | POLYSOM <6 YRS CPAP/BILVL | PA Required for all providers |
95805 | MX SLEEP LATENCY TEST-MX TRIALS-ASSESS SLEEPINES | PA Required for all providers |
95807 | SLEEP STDY VENT-RESP-ECG-O2 SAT-ATTENDED TECH | PA Required for all providers |
95808 | POLYSOM ANY AGE 1-3> PARAM | PA Required for all providers. |
95810 | POLYSOM 6/> YRS 4/> PARAM | PA Required for all providers. |
95803 | ACTIGRAPHY TESTING | PA Required for all providers |
If you have any additional questions about this change, please reach out to your Provider Representative.
Updated 6/26/2024 to update table to accurately reflect PA requirement description.