Wiki EEG's done in the office

[SJFROEMMING]

We have a tech come in to do our EEG's and the Dr does the interpretation. We have always billed these globally as the DOS, however recently, we became aware that the EEG's professional component should be billed the date the test is read which could be several days later.

Please respond how global EEG's should be billed if technical & professional components are not done on the same date.

Any feedback would be welcome.

Thank you,
Sue F

 

[jonest1]

EEG's

From my understanding you should bill the EEG on the DOS performed and the professional part also on the DOS performed no matter when it was read. So if that is incorrect I would like some info on that.

 

[mhstrauss]

Per CMS guidelines, the correct DOS for the prof component is the date the the provider actually performed the interpretation, not necessarily the date the test was performed.

https://www.noridianmedicare.com/provider/updates/docs/mm6375_POS_DOS_Diagnostic_Tests.pdf

HTH!!

 

[Kiracodes]

thought it was rescinded?

I thought CMS rescinded CR6375 in Feb 2010? Stating they would replace with clarification later pending further policy clarification on POS and DOS reporting for interpretations. Was further clarification made by CMS?

Here is the rescind info I found. Am I reading this wrong?

https://www.noridianmedicare.com/cgi-bin/coranto/viewnews.cgi?id=EkyVyuVVFuoxrnxwWz&tmpl=part_b_viewnews&style=part_ab_viewnews

 

[mhstrauss]

I thought CMS rescinded CR6375 in Feb 2010? Stating they would replace with clarification later pending further policy clarification on POS and DOS reporting for interpretations. Was further clarification made by CMS?

Here is the rescind info I found. Am I reading this wrong?

https://www.noridianmedicare.com/cgi-bin/coranto/viewnews.cgi?id=EkyVyuVVFuoxrnxwWz&tmpl=part_b_viewnews&style=part_ab_viewnews

This is the most recent transmittal I could find; from what I'm reading, the CR was rescinded due to corrections about POS, not DOS ?? If anyone else has any more current info, please chime in.

http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R2679CP.pdf

 

[Kiracodes]

Denials?

Would think there would be some denials in some cases

We are doing hospital EEG interps done by the Neurology Hospitalist and not in and office, but would still apply for us too. However we also do 48-72hr+ EEGs along with Ambulatory.

Has anyone experienced denials or having them kick off the claim because an interp has a DOS (if you use the date the official interp was done) AFTER discharge? Or multiple interps billed on the same DOS because they all were interpreted on the same day but different study dates?

 

[SJFROEMMING]

So should we not be billing the global EEG done in our office, codes 95916 or 95919? And instead bill the technical component the date of the visit and then the professional component the date the physician reads the EEG, which may be same date or a day or two later?

Then what is the purpose of the global EEG code?

Thanks for any feedback.

 

[mhstrauss]

So should we not be billing the global EEG done in our office, codes 95916 or 95919? And instead bill the technical component the date of the visit and then the professional component the date the physician reads the EEG, which may be same date or a day or two later?

Then what is the purpose of the global EEG code?

Thanks for any feedback.

The purpose of the global code is for when the tech and prof components are both done on the same day. If that is the case, you can bill the global on one line of the claim, with the appropriate DOS.