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Neurology & Pain Management Coding Alert

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Digital Analysis Doesn't Apply to 95953

Published on Fri May 21, 2004

Question: Can we charge for a digital analysis (95957) with an ambulatory EEG (95953)?

Colorado Subscriber Answer: No, you should not report digital analysis of electroencephalogram (95957, Digital analysis of electroencephalogram [EEG] [e.g., for epileptic spike analysis]) with ambulatory EEG (95953, Monitoring for localization of cerebral seizure focus by computerized portable 16 or more channel EEG, electroencephalographic [EEG] recording and interpretation, each 24 hours). "The services provided when 95957 is reported are performed without the patient being present and are only reported with the specialized procedures described in codes 95816, 95819 or 95954" [emphasis added], according to the AMA's CPT Assistant, November 1998, Vol. 8, No. 11.

Although these guidelines are several years old, the AMA has not revised them: You should continue to report 95957 only with 95816-95819 and pharmacological or physical activation 95954.
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