Neurology & Pain Management Coding Alert

Question: Why does 95816 have a 5.34 relative value and 95819 have 5.00? Is there more work involved in 95816?

Minnesota Subscriber

Answer: Yes, the work associated with 95816 (Electroencephalogram [EEG]; including recording awake and drowsy) is more difficult than with 95819 (- including recording awake and asleep) because the physician is keeping the patient drowsy instead of letting her fall asleep.

The committee that determines procedures- values takes all differences into consideration when setting relative value unit (RVU) levels. When it finds a significant difference between procedures, it establishes different RVU levels -- which helps you gauge the work involved.