Neurology & Pain Management Coding Alert
NCCI Says 'No' to Billing EEG With Physician Attendance
If you've been billing separately for the EEG when the neurologists provides EEG recording during the activation phase of pharmacological or physical activation, NCCI is about to rain on your parade. No More Same-Day Consult and Hospital Admit And NCCI 10.3 now makes initial and follow-up inpatient consultations (99251-99263) components of observation or inpatient hospital care codes 99234-99236.
The latest round of National Correct Coding Initiative edits (version 10.3) now bundles electroencephalogram procedures 95812-95822 into 95954 (Pharmacological or physical activation requiring physician attendance during EEG recording of activation phase [e.g., thiopental activation test]).
Translation: This means that the neurologist cannot bill separately for EEG testing if he is already billing for physician attendance during an EEG.
What this means: You can no longer bill for a consult if the physician also placed the patient under observation or admitted him as an inpatient. There are no circumstances under which you may override the edits using a modifier.
NCCI version 10.3 covers the final quarter of 2004, beginning Oct. 1 and ending Dec. 31.
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