When reading the breakdown of special EEGs, the new Continous EEGS have replaced the old 95951, 95953. I understand it is now comprised of the Technical and Professional Component and can also include the set-up/breakdown/education if applicable.
We are doing the 2-12hrs and do provide and bill the following codes as they apply to each of our patients. 95700, 95713, 95718. So far Palmetto GBA has processed the 95700 & 95718 but denied the 95713. I am not sure why as codes 95713 and 95718 should not require modifiers as the actual wording of it being a technical or professional code is already built into it. So it doesn't make sense that maybe it might require a TC modifier. Has anyone billed Medicare for this and came across the same issue? So far the only carrier that has processed for us is BCBS Anthem and they processed our claim w/these 3 codes without an issue. Can anyone assist further on this or provide more insight?
Thank you
We are doing the 2-12hrs and do provide and bill the following codes as they apply to each of our patients. 95700, 95713, 95718. So far Palmetto GBA has processed the 95700 & 95718 but denied the 95713. I am not sure why as codes 95713 and 95718 should not require modifiers as the actual wording of it being a technical or professional code is already built into it. So it doesn't make sense that maybe it might require a TC modifier. Has anyone billed Medicare for this and came across the same issue? So far the only carrier that has processed for us is BCBS Anthem and they processed our claim w/these 3 codes without an issue. Can anyone assist further on this or provide more insight?
Thank you