Anesthesia Coding Alert

Question: Can we report 95955 in addition to the anesthesia code? I understand it's an integral pat of the anesthesia service and is not separately billable. However, some anesthesiologists in our area are billing for the procedure and getting paid.

Answer: Correct Coding Initiative (CCI) edits consider 95955 (Electroencephalogram [EEG] during nonintracranial surgery [e.g., carotid surgery]) an integral part of the anesthesia service. The American Society of Anesthesiologists also does not support billing 95955 when providing anesthesia because the physician uses the EEG for "noninvasive monitoring." Medicare and some other payers also do not separately reimburse 95955.

Exception: Don't give up hope. Some carriers do not follow CCI, so a physician group might make contractual arrangements with its carrier to reimburse the service separately. Because of this, check whether your carrier adheres to CCI guidelines to determine whether to report 95955.