Neurosurgery Coding Alert

Question: If a physician performs a two-hour and 30-minute functional cortical and subcortical mapping by stimulation and recording of electrodes on the brain surface, is it appropriate to report 95961 for the initial hour and 95962 twice for the additional one hour and 30 minutes?

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Answer: Not in this instance, according to CPT Assistant (August 2010). "The provider must perform 31 minutes or more of this service to qualify for an hour in the various per-hour codes, including 95962 (Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of physician attendance (List separately in addition to code for primary procedure)."

If the physician performs the procedure "for 1 minute over the stated 2 hours and 30 minutes, one would code as stated," CPT Assistant states. Therefore, you would report "2 hours and 31 minutes as one unit of 95961 (Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of physician attendance) and two units of code 95962." In contrast, 2 hours and 30 minutes is one unit of code 95961 and one unit of code 95962.