Neurosurgery Coding Alert

Hint: Report 95700 only once per recording period.

You may be stumped if your physician reports long-term continuous electroencephalogram (EEG) and video electroencephalogram (VEEG) recording services because CPT^® offers a plethora of guidelines you must follow if you want to submit clean claims. For example, you must know how long the recording services lasted and how to report the initial set-up.

Read on to learn the five rules you should follow when reporting these recording services in your neurosurgery practice.

Rule 1: Know When to Report Long-Term Continuous Recording EEG Services

If your physician performs long-term continuous electroencephalogram (EEG) and video electroencephalogram (VEEG) services, you will look to codes 95700 (Electroencephalogram (EEG) continuous recording, with video when performed, setup, patient education, and takedown when performed, administered in person by EEG technologist, minimum of 8 channels) through 95726 (Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of EEG recording, with video (VEEG)).

Your physician may perform long-term continuous recording EEG services to determine the type and location of seizures, to differentiate seizures from other abnormalities, determine the specific type or location of seizures, and monitor the treatment of seizures and status epilepticus, for example.

What happens during the procedure: A long-term continuous recording EEG procedure captures the patient’s brainwave activity for two hours or greater.

Rule 2: Rely on 95700 for Long-Term EEG Setup

You should report code 95700 for long-term continuous EEG/VEEG recording, setup, takedown when performed, and patient/caregiver education the EEG technologist(s) performs, per CPT^®. Code 95700 is part of the technical component code range for long-term continuous EEG recording, which includes codes 95700 through 95716 (Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance).

You should report code 95700 for long-term EEG setup only when an EEG technologist performs this service in person. Report 95700 only once per recording period on the date the technologist performs the setup.

Caution: When you report 95700, make sure the setup includes a minimum of eight channels of EEG. If the service uses fewer than eight channels, then you should report 95999 (Unlisted neurological or neuromuscular diagnostic procedure). Additionally, if an individual who does not meet the definition of an EEG technologist, as defined by the guidelines, performs the setup, then you should report 95999, not 95700.

Rule 3: Look to These Codes for EEG Technical Component

CPT^® divides the remaining technical component codes 95705-95716 into different groups, depending upon the duration of the service and whether video is utilized:

• 95705 (Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, 2-12 hours; unmonitored)-95707 (… with continuous, real-time monitoring and maintenance)
• 95708 (Electroencephalogram (EEG), without video, review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored)- 95710 (… with continuous, real-time monitoring and maintenance)
• 95711 (Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, 2-12 hours; unmonitored)-95713 (… with continuous, real-time monitoring and maintenance)
• 95714 (Electroencephalogram with video (VEEG), review of data, technical description by EEG technologist, each increment of 12-26 hours; unmonitored)- 95716 (… with continuous, real-time monitoring and maintenance).

Don’t miss: Codes 95705-95716 include monitoring, maintenance, review of data, and creating a summary technical description.

Medical documentation: You should take heed of multiple details in the medical documentation when reporting the technical EEG codes including whether the EEG technologist captured diagnostic VEEG in conjunction and simultaneously with the EEG service and the type of technologist monitoring used for the study.

Rule 4: Focus on 95717-95726 for Professional EEG Component

For the professional component of the long-term continuous recording EEG codes, you should report codes 95717 (Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation and report, 2-12 hours of EEG recording; without video) through 95726 (Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of EEG recording, with video (VEEG)).

Codes 95717-95726 includes when your physician reviews, analyzes, interprets, and report the EEG/VEEG results with their recommendations based upon the findings. However, you may report evaluation and management (E/M) services separately, per CPT^®.

You will pick the appropriate professional component EEG coding based upon the length of the recording your physician interprets and when your physician generates his reports.

Rule 5: Timing is Everything for Both Technical, Professional Components

Making sure your physician documented the exact time involved with both the technical and professional components of the EEG recording services is vital to submitting clean claims.

Technical component: When it comes codes 95705-95716, you must know exactly how long the recording lasted. For example, you should only report VEEG codes 95711-95716 only “if diagnostic video of the patient is recorded a minimum of 80% of the time of the entire long-term VEEG service, concurrent with diagnostic EEG recording …,” according to CPT^®.

Bottom line: You cannot report the VEEG study codes if the concurrent diagnostic video occurs less than 80% of the entire study.

You can report codes 95705-95707 and 95711-95713 when the total diagnostic recording time is between 2 and 12 hours “or to capture the final increment of a multiple-day service when the final increment extends 2 to 12 hours beyond the time reported by the appropriate greater-than-12-hour-up-to-26-hour code(s) (95708, 95709, 95710, 95714, 95715, 95716),” per CPT^®. “A maximum of one 2-12 hour code may be reported for an entire long-term EEG service.”

Professional component: You must also follow these specific guidelines regarding time when reporting codes 95717-95726:

• Report codes 95719 and 95720 for greater than 12 hours up to 26 hours of recording.
• Report codes 95717-95720 when the daily professional reports are generated during the longer-term recording or when the time of the recording for the entire study is between two and 26 hours.
• Report codes 95717 and 95718 “a maximum of once for an entire long-term EEG service to capture either the entire time of service or the final 2-12 hour increment of a service extending beyond 24 hours,” per CPT^®.
• Report codes 95719 and 95720 only once for a recording period greater than 12 hours up to 26 hours. But, if the study spans multiple days, you may report codes 95719 and 95720 after each 24-hour period during the extended recording period.
• If the study lasts longer than 26 hours, you can report code 95717 or 95718 in conjunction with codes 95719 or 95720.
• If the entire study includes recording that is greater than 36 hours, and the physician or other qualified health professional performs the professional interpretation after the entire recording is complete, you should report codes 95721-95726.