ED Coding and Reimbursement Alert

Question: We have purchased a biologic digital electroencephalography (EEG) machine and have two sets of ideas on coding correctly. What CPT codes should we use 95816 or 95957 or both together? We also bill 95954 EEGs and 95953 for ambulatory services.

Betty Davidson
Neurology Center of Fairfax, Fairfax, Va.

Answer: An EEG with digital analysis should be reported with both the EEG digital analysis code (95957) and the appropriate EEG code in the CPT 95812-95827 range. EEG monitoring for seizure focus with digital analysis should be reported with the appropriate monitoring code (95950-95953, 95956) as well as the EEG digital analysis code (95957).

If pharmacological or physical activation requiring physician attendance were also provided, the code for this (95954) would also be reported.

As an example, if your clinic provided 24-hour monitoring for activation of seizure focus by computerized portable EEG with 16 or more channels and pharmacological or physical activation requiring physician attendance was utilized along with digital analysis of the EEG, then you would report three CPT codes: 95953, 95954 and 95957.