Neurology & Pain Management Coding Alert

Question: What is the appropriate code to report electrosleep therapy?

Kentucky Subscriber

Answer: Electrosleep therapy describes the use of short-duration, low-amplitude pulses of direct current to the patient's brain via externally placed electrodes, and may be used to treat conditions such as chronic insomnia, anxiety and depression, as well as psychosomatic and organic disorders (tension headache, essential hypertension). CPT does not contain a code for this service. Therefore, the best code choice is 95999 (Unlisted neurological or neuromuscular diagnostic procedure). Be sure to supply complete documentation to describe the procedure.

Be aware that Medicare and most private payers do not reimburse for electrosleep therapy and consider it an investigational treatment. Medicare policy says, "Until scientific assessment of this technique has been completed and its efficacy is established, no program payment may be made for electrosleep therapy."

Clinical and coding expertise for You Be the Coder and Reader Questions provided by Neil Busis, MD, chief of the division of neurology and director of the neurodiagnostic laboratory at the University of Pittsburgh Medical Center at Shadyside, and clinical associate professor in the department of neurology, University of Pittsburgh School of Medicine; and Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, director and senior instructor for CRN Institute, an online coding certification training center based in Absecon, N.J.