Neurology & Pain Management Coding Alert

Question: Our physician often completes cognitive testing and EEGs on one day for a patient. Can I report both services? If so, should I append modifier 59?

Iowa Subscriber

Answer: Your physician can perform both services on the same day, which you would code with 96118 (Neuropsychological testing [e.g., Halstead-Reitan Neuropsychological Battery, Wechsler Memory Scales and Wisconsin Card Sorting Test], per hour of the psychologist's or physician's time, both face-to-face time with the patient and time interpreting test results and preparing the report) and the appropriate choice from 95812-95827 for the electroencephalogram (EEG).

The answer regarding payment for both services depends partly on the carrier in question. Some carriers, such as Blue Cross/Blue Shield, only pay for one of these services per day (though you-ll still want to report both services for accuracy's sake, and so you can refile with the secondary carrier or bill the patient if necessary). Some Medicare carriers, however, will pay for both services on the same day. If you report both services to Medicare, append modifier 59 (Distinct procedural service) to indicate separate procedures.