Neurology & Pain Management Coding Alert

Question: Is it correct to bill a technical component with 95819? If so, how do we handle it?

Kansas Subscriber

Answer: In the Medicare Physician Fee Schedule, CPT® code 95819 (Electroencephalogram [EEG]; including recording awake and asleep) does have separate professional and technical components. Reporting the technical component to go with 95819 depends on the situation.

• If you’re billing for both the recording and interpretation, submit 95819 “globally” or with no modifiers.
• If you’re billing only the technical component (performing the EEG recording only), append modifier TC (Technical component).
• If you’re billing only for the physician’s interpretation of the EEG diagnostic test (also known as the professional component), append modifier 26 (Professional component).