Physicians and technologists have their own CPT^® codes for these tests.

When a patient presents with a clinical concern that leads the physician to suspect seizures or an unexplained episodic event, they may order an electroencephalogram (EEG) to review the electrical activity in the patient’s brain.

While you’ll report many tests with a single CPT^® code and add modifiers for the technical component and professional component, EEG tests are different. You’ll report the technician’s work performing the actual EEG with one set of codes, while you’ll code the provider’s interpretation and report using different codes. Because of this anomaly, coders must be aware of the differences between the two code sets when reporting these separate services.

Read on for a primer on pairing the proper CPT^® code with the EEG service that the physician or technician provides.

Use These Codes for EEG Techs

The EEG technologists’ code range is 95705 (Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, 2-12 hours; unmonitored) through 95716 (Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance).

Some reasons to order an EEG are as follows:

• New-onset seizure-like episode
• Recurrent unexplained episodes of staring or unresponsiveness
• Altered mental status
• Unexplained loss of consciousness
• Suspected epilepsy
• Differentiation of epileptic seizures from nonepileptic events
• Monitoring response to antiseizure treatment
• Critically ill patient with unexplained alteration in consciousness

Identify the Different Types of EEG

The codes in the 95705-95716 set are distinguished by how long the patient was wearing the equipment and if the session was monitored. In addition, it is important to note whether the encounter included video.

An unmonitored EEG occurs when the test is recorded but a technician or physician is not monitoring the recording. These tests can be done at home, with the patient wearing the equipment and then turning it in to retrieve the data for later review. The codes that cover this method are 95705, 95708 (Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored), 95711 (Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, 2-12 hours; unmonitored), and 95714 (Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored).

Intermittent monitoring occurs when the recording is monitored periodically but not continuously and is common in long-term monitoring situations. A technician may periodically review the recording and address any technical changes. The codes for intermittent monitoring include 95706 (… with intermittent monitoring and maintenance), 95709 (… with intermittent monitoring and maintenance), 95712 (… with intermittent monitoring and maintenance), and 95715 (… with intermittent monitoring and maintenance).

Continuous monitoring occurs when a technician is monitoring in real time to identify significant EEG changes and any episodes that the EEG may pick up, as well as addressing any recording or technical problems. Codes 95707 (… with continuous, real-time monitoring and maintenance), 95710 (… with continuous, real-time monitoring and maintenance), 95713 (… with continuous, real-time monitoring and maintenance), and 95716 (… with continuous, real-time monitoring and maintenance) cover continuous monitoring EEG.

Use These Codes for Physician Services

When a physician or other qualified healthcare professional (QHP) reviews the test results and performs an interpretation and report, you’ll use codes 95717 (Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation and report, 2-12 hours of EEG recording; without video) through 95726 (Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of EEG recording, with video (VEEG)). These codes refer to the method, length of time the patient wore the equipment, and monitoring, if applicable. This does not mean that the physician has to perform the test and utilize their own equipment. Instead, it is to report the interpretation of the EEG performed by the technician.

Report 95717-95726 when a physician or other QHP reviews the recorded events and data of the specified EEG and produces an interpretation and report. This is the professional component of the EEG. A QHP includes any individual who is qualified to perform this service within the scope of practice according to law, regulation, and the facility’s policy.

Check out These Coding Examples

Example 1

Chief complaint: Episodes of staring and loss of awareness

A 27-year-old patient reports episodes of staring and unresponsiveness occurring multiple times a week. The routine, short-term EEG produced no diagnosis, leading to the need for a longer recording to capture an episode.

Physician actions: The neurologist reviews the history of the patient’s episodes and the prior EEG. They perform a neurologic examination and determine that a prolonged ambulatory video EEG is medically necessary and appropriate. The neurologist orders a 24-hour ambulatory video EEG.

The EEG occurs at home after the technician applies electrodes and initiates the recording. The neurologist then reviews the EEG data and video recordings and produces a report of their interpretation.

Coding: On this claim, report the following:

• 95716 for the technologist’s services
• 95720 (Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of EEG recording, interpretation and report after each 24-hour period; with video (VEEG)) for the neurologist’s services
• R40.4 (Transient alteration of awareness) appended to 95716 and 95720 to represent the patient’s condition

Example 2

Chief complaint: Continuing to have recurrent unresponsive episodes while taking antiseizure medication

A 42-year-old with focal epilepsy continues to experience episodes of unresponsiveness despite compliant treatment.

Physician actions: The neurologist orders a long-term, 48-hour video EEG upon reviewing the clinical history and medical necessity. Upon receiving the recording, the neurologist reviews the video, evaluates the data for abnormalities and seizure activity, and compares these findings with the reported events given during the clinical visit. The report included an interpretation signed by the physician.

Coding: On this claim, report 95722 (Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 36 hours, up to 60 hours of EEG recording, with video (VEEG)) for the EEG interpretation with

G40.209 (Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus) appended to represent the patient’s epilepsy.

Gabbi Gifford, CPC, CDEO, CPMA, CRC, CVBA, Contributing Writer