Neurology & Pain Management Coding Alert

Question: My neurologist performed an EEG with video monitoring for eight hours. How should I code the service, based on how long the test took?

Connecticut Subscriber

Answer: Code 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) applies to special EEG testing, such as localization of cerebral seizures with video recording. Your neurologist's documentation should include the actual number of hours the study lasted.

Modify it: The December 2004 CPT Assistant clarified that for code 95951, "if less than 12 hours of recording time is provided, then the reduced services modifier 52 (Reduced services) should be appended to identify the reduction of service. If the recording time is 12 hours or more, the 52 modifier is not necessary."