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Neurology & Pain Management Coding Alert

Increase Pay Up with Proper Coding for EEG Studies

Published on Wed Dec 19, 2012

The proper coding for an EEG depends on several factors, including the length of time during which the monitoring takes place and whether sleep was achieved during the test. Careful documentation and a firm grasp of carrier rules will help to ensure optimum reimbursement. EEGs are used to diagnose such diverse disorders as dementia (294.8), mental retardation (319), epilepsy (345.xx), cognitive changes and memory loss (780.9), and sleep-related disorders (780.50).

CPTs rules for electroencephalogram (EEG) codes dictate that the full procedure can be billed only if the neurological practice owns the equipment. If the test takes place in another location (like a sleep studies lab), if nonpracticing technicians are employed for monitoring or if it occurs in the operating room during surgery, the codes must be billed with modifier -26 (professional component). When billing for the professional component, the physician should record what was done during [...]
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