Neurology & Pain Management Coding Alert

Question: We performed video EEG in our office and the patient was retained for overnight monitoring. Is there a facility charge/code we can bill or does this fall under professional and technical component?

Maryland Subscriber

Answer: The CPT® code to report video electro-encephalograph (EEG) is 95951 (Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, combined electroencephalographic [EEG] and video recording and interpretation [e.g., for presurgical localization], each 24 hours).

Before coding the procedure, look for the duration of video EEG. According to CPT®, you use codes 95950-95953 and 95956 per 24 hours of recording. You do not need to append modifier 52 (Reduced services) for recording of more than 12 hours. For recording 12 hours or less, you will use modifier 52. When will see that the descriptor of code 95951 mentions 'recording and interpretation,' meaning that the code is inclusive of interpretations made through the recording. These interventions may aim to alter or end the recording or to alter the patient care during the recordings as needed. If the video EEG extends beyond 24 hours, you can report multiple units of 95951.

If the neurologist only provides the interpretation and report, append modifier 26 (Professional component). This clarifies that the physician does not incur the cost of running or maintaining the necessary equipment covered by the full payment of 95951.

Note: Video EEG is also known as video EEG monitoring (VEM). VEM gives a simultaneous recording of EEG, sound, and video to map the patient's behaviour and brain electrical activity. This helps to distinguish epileptic seizures from other conditions, determine the seizure type(s), and localize foci in the brain where the seizures arise.