Neurology & Pain Management Coding Alert

Reduce denials for your practice by reading the fine print. There are always a few tricky codes out there that can cause denials from carriers. Take a few minutes to test yourself against these quick, easily solved issues to reduce compliance errors. Tip 1: Beware of Tricky PC/TC Components Scenario: Your neurologist performs a sleeping or comatose EEG in the hospital ICU with a facility's equipment. You should use 95822 (Electroencephalogram [EEG]; recording in coma or sleep only) and append modifier 26 (Professional component). Common mistake: Some coders might mistakenly report the diagnostic study without any modifiers. But EEG code 95822 is made up of two components: the technical component (modifier TC) and the professional component (modifier 26). TC is for the person or facility which actually owns the equipment, says Peggy Stilley, CPC, office manager for an Oklahoma University-based private physician practice in Tulsa. The 26 modifier is for [...]