# CPT 95951 Video EEG - Neurology



## pmersing2002@yahoo.com (Apr 27, 2017)

Can anyone with experience or someone who does neurology billing and/or coding assist me with this issue? Can a provider bill CPT code 95951 if they are hooking the patient up in their office (POS code 11) or even using a third party company who specializes in Video EEGs but then sending the patient home without trained personnel to monitor them? Can they monitor the patient while the patient is at home and the trained personnel is in another location? It is my understanding that someone (ie the doctor or a trained professional) has to be able to intervene or alter treatment if necessary so it would not make sense to bill for CPT 95951. I am just trying to get some clarification on billing for this CPT code.


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## LindaDuckworth (Aug 14, 2017)

*CPT 95951 Video EEG - Neurology - not the right code*

I have been researching extensively.  Ambulatory video EEG testing, at home, is not reported with 95951.  This is intended more for a facility setting.  My evidence, so to speak, comes from:

1.  a personal conversation with a physician who sits on the RUC committee and said it is "never appropriate to use it for in home testing".  My apologies, I do not have his permission to release his name.  This conversation took place in mid to late June, 2017.  We had an extensive conversation about the code's intent, how the RVUs were set up... you name it, he had an answer.

2.  WPS Medicare, I have it in writing, says this is not the code to use (received the response 08/10/17).    Here is a copy of our questions we submitted, and their answers:

Thank you for contacting Wisconsin Physicians Service (WPS) Government Health Administrators (GHA) for assistance regarding Medicare’s definition of “attended” as it pertains to CPT codes 95951 and 95953.  Your inquiry also asks for billing guidance concerning these codes.

I consulted with our Medical Policy staff concerning your request.  The response below is reflective of the response I received.  

In this instance, the term “attended” or “attendance” means physically being there.  Regarding your specific billing questions, I have restated your questions to correspond with the responses.

Question 1:
If a testing facility is doing 24-hour monitoring with certified staff of the EEGs, with video recording, in the patient’s HOME, then is code 95951 appropriate?

Response 1:
No.  The service requires attendance.  Live feeds or telemetry is not the same as “attendance.”

Question 2:
If a testing facility is doing less than 24-hour monitoring with certified staff of the EEGs, with video recording, in the patient’s home, then is code 95951 appropriate?

Response 2:
No.  The CPT code is used per 24 hours and attendance would not have been met.

Question 3:
If the patient has the camera set up in their living room, and a technician is monitoring via “live feed”, does this qualify for “attendance”, making 95951 the correct code? (of course, assuming all other qualifiers were met).

Response 3:
No.  That does not qualify for payment consideration.

If you require coding assistance, we suggest you seek professional coding assistance, as the WPS Staff are not professional coders.  We have an article on website that explains this in more detail and provides coding resources you may find beneficial.  The article is available on our website at: https://www.wpsgha.com/wps/portal/mac/site/claims/faqs

For your convenience, I am including verbiage from the question/answer.

Question:
Can Medicare help me determine the appropriate codes to use on my claims?

Answer:
Per regulations in the IOM Publication 100-09, Chapter 6, Section 30.1.1, Medicare contractors are prohibited from providing coding advice to providers.  Providers are responsible for determining the correct diagnostic and procedural coding for the services they furnish to Medicare beneficiaries.  Providers with inquiries about interpretation of procedural and diagnostic coding, should refer to the resources provided in the IOM noted above.
If you need additional assistance from our office regarding this matter, please include the reference number above in any correspondence.  If you need immediate assistance, you may reach our Provider Contact Center by calling 866-518-3285 and selecting “General Inquiries.”


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## Launie75 (Jun 28, 2018)

*95951 VS 95953 unattended home video EEG ??*

Yes if someone can provider greater clarification.. I too am finding mixed reviews on 95953 vs 95951... 95951 is the only one to specifically state video... but Aetna policy considers 95953 as home video... We keep getting denials from UHC when using 95951 once we submit our records. It is all the same technical set up by UHC approves half and then state on other half it is not the right code even though the technical component is the SAME... 

so is the difference is 95953 is home w/wo video unattended computerized portable


would these state that they are not portable and remain in office?
95951 is consistent clinical attendance w/video?  CPT doesn't show anything about this code being attended? States video & eeg 24hr cable/radio

95956 makes NO mention of video but says attended by nurse or tech cable/radio


http://www.aetna.com/cpb/medical/data/400_499/0425.html
Aetna considers the combined use of ambulatory EEG and home-video recording an equally acceptable medically necessary alternative to ambulatory EEG alone. Note: Ambulatory EEG with home video recording is correctly coded as ambulatory EEG (CPT code 95953); the video EEG (95951) and attended EEG (95956) CPT codes require contemporaneous in-person attended monitoring (AMA, 2014).


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## jflynn (Jul 9, 2019)

I've spend many hours of research and correspondence to get my question answered on this myself. Listed below is the response per the American Academy of Neurology:

This email is in response to you inquiries about correct coding for 95951. The challenge with the existing CPT language is that is it not very clear, specifically when it comes to attended vs. unattended and with or without video.  Any ambulatory EEG (with or without video) should be reported with 95953.  Codes 95951 and 95956 is for attended studies; for “recordings in which interpretations can be made throughout the recording time, with interventions to alter or end the recording or to alter the patient care during the recordings as needed.”  95956 is without video, 95951 with video.



“Video” is not listed in the code description of 95953 which leads people to incorrectly select 95951, but 95953 should be coded for unattended home portable ambulatory EEG. There is actually an AMA CPT Assistant article  (December 2014 issue) that addresses this very issue:

*Question*: Is CPT code 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 (eg, for presurgical localization), each 24 hours_, the correct code to report for an unattended home portable ambulatory video EEG?



*Answer*: No. Code 95953, _Monitoring for localization of cerebral seizure focus by computerized portable 16 or more channel EEG, electroencephalographic (EEG) recording and interpretation, each 24 hours, unattended_, should be reported for an unattended home portable ambulatory video EEG.



This guidance is based on the actual CPT language and what most carriers model their coverage policies after.  The AAN teaches that in order to report 95951 it must be an attended study



Hope this helps!


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## Rubybe (Jul 29, 2019)

jflynn said:


> I've spend many hours of research and correspondence to get my question answered on this myself. Listed below is the response per the American Academy of Neurology:
> 
> This email is in response to you inquiries about correct coding for 95951. The challenge with the existing CPT language is that is it not very clear, specifically when it comes to attended vs. unattended and with or without video.  Any ambulatory EEG (with or without video) should be reported with 95953.  Codes 95951 and 95956 is for attended studies; for “recordings in which interpretations can be made throughout the recording time, with interventions to alter or end the recording or to alter the patient care during the recordings as needed.”  95956 is without video, 95951 with video.
> 
> ...


Hi, please elaborate on CPT language.  Does the 95951 code description state that this procedure requires contemporaneous attendance?  Your information will be very appreciated.


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## jflynn (Aug 5, 2019)

For CPT 95951 the lay description is as follows:

"The physician places sensors on a patient's head in an electroencephalogram (EEG) to measure and record the brain's electrical activity. This code applies to a 16 or more channel telemetry EEG, combined with video recording and interpretation, to evaluate and monitor presurgical localization of the specific area where the cerebral seizure emanates and applies to each 24-hour period of monitoring."

I hope this helps!


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## krisfelty (Aug 6, 2019)

FYI::::::

Check the proposed rule for 2020. EEG coding changes as well as RVUs drastically,  coming up Jan 1, 2020. Deleting existing codes 95950, 95951, 95953 and 95956. 10 new codes for PC and 13 for TC. 

Kristin Felty CPC, CCC, CCVTC


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## agavic09 (Aug 8, 2019)

New Questions, couldn't get it to post in a new thread; does anyone know the answers to the following?


How do you report/bill for MEP ( motor evoked potential) for cranial nerves only?
How do you report/bill for intro operative monitoring when not mapping?


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