Neurology & Pain Management Coding Alert

Question: Our technician began a 24-hour EEG, but the patient took off the machine after 20 hours. Can we still bill the full amount for 95953?

Tennessee Subscriber

Answer: The CPT® section guidelines for Special EEG tests direct providers that codes 95950-95953 are used per 24 hours of recording. For recording more than 12 hours, do not use modifier 52. For recording 12 hours or less, use modifier 52. Additionally, according to the American Academy of Neurology and the American Clinical Neurophysiology Society, more than half of the 24 hours of monitoring is adequate to use the EEG codes.

Because of this, you can still charge the full 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) because the test lasted longer than 12 hours.

Note: If the recording time had been less than 12 hours, you should bill 95953 with modifier 52 (Reduced services...) to indicate the service was reduced in some way. Then indicate the actual number of hours that it was performed.