Neurology & Pain Management Coding Alert

Question: My neurologist performed an EEG with video monitoring for eight hours. How should I code the service, taking into account the length of time the EEG took? North Dakota Subscriber Answer: The CPT section guidelines for Routine Electroencephalography indicate "Extended EEG codes 95812-95813 include reporting times longer than 40 minutes." This section also includes a parenthetical note directing coders to review codes 95950-95953 or 95956 for 24-hour EEG monitoring. You should use 95951 (Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, combined electroencephalographic [EEG] and video recording and interpretation [e.g. for presurgical localization], each 24 hours) to report special EEG testing such as localization of cerebral seizures with video recording. The documentation for this time-based code should include the actual number of hours the study was performed. The December 2004 CPT Assistant clarified that for code 95951, "if less than 12 hours of recording time is provided, then the reduced services modifier 52 (Reduced services) should be appended to identify the reduction of service. If the recording time is 12 hours or more, the 52 modifier is not necessary."