Neurology & Pain Management Coding Alert

Question: What things should we look for in a patient's chart before coding extended EEG monitoring with 95812 or 95813?

South Carolina Subscriber

Answer: According to the American Academy of Neurology and other sources, "routine length" of monitoring is now defined as 20 to 40 minutes. You'll turn to the extended monitoring codes for times greater than 40 minutes. As noted in the descriptors, 95812 (Electroencephalogram [EEG] extended monitoring; 41-60 minutes) represents monitoring lasting 41 to 60 minutes and 95813 (... greater than 1 hour) is for monitoring lasting longer than an hour. Look in your provider's note for documentation of extended time.

Replacements: Depending on the circumstances, you could report 95812 or 95813 in place of 95816 (Electroencephalogram (EEG); including recording awake and drowsy), 95819 (... including recording awake and asleep), or 95822 (...recording in coma or sleep only). You cannot, however, bill 95812 or 95813 and either 95816, 95819, or 95822 for the same EEG study.