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Ace Routine And Extended EEG Coding With These Pointers by James Smith
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Ace Routine And Extended EEG Coding With These Pointers |
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Health
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Exact timing of EEG monitoring is crucial, frequency is not important.
While reporting EEG recording, the most vital factor is to time the procedure. In case your physician uses advanced methods, video and digital recordings; you may be faced with added medical coding challenges for these services. Read on to prepare yourself on how to accurately time the procedure along with code the routine, extended, and special monitoring.
Look For How Long the Diagnostic Study Continued
While reporting EEG, you must look for how long your neurologist took to perform the monitoring. Monitoring that lasts 20 to 40 minutes is taken as routine. You will report CPT codes for extended monitoring in case the procedure goes beyond 40 minutes in duration. For EEG recording that lasts 41 to 60 minutes, you must report 95812 (Electroencephalogram [EEG] extended monitoring; 41-60 minutes), and in case it lasts more than an hour, you would report 95813 (Electroencephalogram [EEG] extended monitoring; greater than 1 hour).
It is significant that your neurologist's report evidently documents the actual EEG recording time. Medical coding is based on the recording though it is underway and the neurologist or technician is collecting data. You do not involve the set-up and take-down time..
Exception: CPT® does not include EEG CPT codes 95824 (Electroencephalogram [EEG]; cerebral death evaluation only), 95827 (Electroencephalogram [EEG]; all night recording), and 95829 (Electrocorticogram at surgery [separate procedure]) from a time component as these are unique services rendered by the physician to monitor a certain pathological condition or diagnose one.
Important note: You can report CPT codes 95812 or 95813 instead of 95816 (Electroencephalogram [EEG]; including recording awake and drowsy), 95819 (… including recording awake and asleep) or 95822 (… recording in coma or sleep only), however you cannot report them together. There is a thin line between drowsy and asleep. You report 95819 when the patient in reality slept during the monitoring. In case the patient did not achieve sleep in a procedure that intended monitoring in sleep, you report 95816 as an alternative.
In case the neurology specialist carries out the global diagnostic service, i.e. owns the equipment, employs the technical staff as well as interprets the diagnostic findings, then the EEG code would be billed without any modifiers. On the other hand, you would append modifier 26 (Professional component) to the EEG CPT® code, in case your neurologist only carries out the professional interpretation of the diagnostic study.
Scan For Video and Channels in Extended Monitoring
For 24-hour EEG monitoring, you should assess CPT codes 95950 (Monitoring for identification and lateralization of cerebral seizure focus, electroencephalographic [e.g., 8 channel EEG] recording and interpretation, each 24 hours)-95953 (Monitoring for localization of cerebral seizure focus by computerized portable 16 or more channel EEG, electroencephalographic [EEG] recording and interpretation, each 24 hours, unattended) or 95956 (Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic [EEG] recording and interpretation, each 24 hours, attended by a technologist or nurse).
Related Articles -
Medical Coding, CPT Codes,
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