Neurology & Pain Management Coding Alert

Reader Questions:

Patient Must Be Asleep During EEG to Report 95819

Published on Fri May 21, 2010

Question: My neurologist administered an EEG that lasted for an hour. The notes from the encounter say that the patient was drowsy, but didn't actually fall asleep during the test. I'm not sure now how to interpret that. What's the correct code for this situation?

Wisconsin Subscriber

Answer: When a neurologist documents that a patient did not fall asleep during an Electroencephalogram (EEG) exam, you should submit 95816 (Electroencephalogram [EEG]; including recording awake and drowsy). Coding an EEG test correctly depends on having all the proper documentation from your physician. You may want to query him for more information before coding, just to be safe.

Note that for coding purposes, there is a big difference between a patient who is "drowsy" and one who is asleep. So even though your neurologist may normally perform sleep EEG studies, this distinction is why you can't report 95819 (...including recording awake and asleep) without a review of the documentation.

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