95811 prior authorization | Premera Blue Cross of Washington

95811, Polysomnography; sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 95811
Description: Polysomnography; sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist
Source: Clinical Review by Code List PBCWA, Pg 522 Original policy

Premera Blue Cross of Washington prior authorization

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