Neurology & Pain Management Coding Alert

An example provided in the article on intraoperative monitoring in the January 2002 issue, page 5, indicated that the code for a baseline EEG is 95816. However, CPT does not list 95816 as a primary procedure for +95920.
  
For 2002, CPT includes an explanatory paragraph with +95920 (Intraoperative neurophysiology testing, per hour [list separately in addition to code for primary procedure]), as follows:
 
"Code 95920 describes ongoing electrophysiologic testing and monitoring performed during surgical procedures. Code 95920 is reported per hour of service, and includes only the ongoing electrophysiologic monitoring time distinct from performance of specific type(s) of baseline electrophysiologic study(ies) (95860, 95861, 95867, 95868, 95900, 95904, 95933, 95934, 95936, 95937) or interpretation of specific type(s) of baseline electrophysiologic study(ies) (92585, 95822, 95925, 95926, 95927, 95930). The time spent performing or interpreting the baseline electrophysiologic study(ies) should not be counted as intraoperative monitoring, but represents separately reportable procedures. Code 95920 should be used once per hour even if multiple electrophysiologic studies are performed. The baseline electrophysiologic study(ies) should be used once per operative session."
 
Although many clinical neurophysiological studies are included in this description (as well as the code descriptor), CPT guidelines do not preclude reporting other electrodiagnostic procedures that may be performed in the operating room. If 95816 (Electroencephalogram [EEG] including recording awake and drowsy [including hyper-ventilation and/or photic stimulation when appropriate]) is performed preoperatively to establish a baseline for comparison, it may be billed separately. Code 95822 (Electroencephalogram [EEG]; sleep only) may be reported in addition to the appropriate number of units of 95920 for the intraoperative monitoring. Documentation should include the exact start and stop times to justify the units of 95920 reported.
 
Note: January's feature neglected to note that 95822 should be reported in addition to the baseline study (95816) and intraoperative monitoring (+95920).