95810 prior authorization | Premera Blue Cross of Washington

95810, Polysomnography; sleep staging with 4 or more additional parameters of sleep, attended by a technologist These criteria do not imply or guarantee approval., is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 95810
Description: Polysomnography; sleep staging with 4 or more additional parameters of sleep, attended by a technologist These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 521 Original policy

Premera Blue Cross of Washington prior authorization

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