CPT^® 95816, Under Routine Electroencephalography (EEG) Procedures

The Current Procedural Terminology (CPT^®) code 95816 as maintained by American Medical Association, is a medical procedural code under the range - Routine Electroencephalography (EEG) Procedures.

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Summary

Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG during awake and drowsy states of the patient.

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Claim Rejected by Payor for "Potential Coding Error"?

[QUOTE="carlystur, post: 511658, member: 412855"] For context: Our providers regularly do Brainscopes (EEGs 95816 and Neuro Psych testing 96132) on patients who have had auto accidents or other reason... [ Read More ]

Claim Rejected by Payor for "Potential Coding Error"?

For context: Our providers regularly do Brainscopes (EEGs 95816 and Neuro Psych testing 96132) on patients who have had auto accidents or other reasons why a patient might have gotten a concussion. On... [ Read More ]

BCBS of GA denied S06.0x0a for diagnosis inconsistent with procedure for EEG 95816

One of our billers (in a neurology office) is notifying me that, because the reason for the procedure was listed under different icd-10-cm codes, the encounter for the procedure should get those other... [ Read More ]

EEG for awake and alert patient

Did you check CPT Assistant or any references from AAN? Can a 52 modifier be used possibly? [URL unfurl="true"]https://www.aan.com/globals/axon/assets/3270.pdf[/URL] "Q: What is the difference betwee... [ Read More ]

Provider Self Treating

[QUOTE] I've been told the company bills 95816 as part of brain training. [/QUOTE] OK, you can always submit a question to the MAC directly. However, I'm also wondering if the EEG would be covered by... [ Read More ]

Provider Self Treating

I really appreciate everyone's input. This is a relative new remote job. A newly open clinic as of 2020. Yes, I have sent several emails concerning this along with the AMA code of Ethics Opinion 1.2.1... [ Read More ]

EEG denying for awake and drowsy

Just had first 95816 denied for that reason...have no idea what it is about.... [ Read More ]

EEG for awake and alert patient

I know this has been a long time ago, but did you ever get a resolution to this? I am having a rash of denials because Dr only did awake part of EEG and insurance is denying because they are saying 95... [ Read More ]

95816 Coding

Hello, I realize this post is old. Did you ever find a solution? I am getting denials for this code. Our Doc did an EEG awake and 95816 was billed. Insurance is denying stating medical records submitt... [ Read More ]

95816 Denials

I am stumped on this one. Doc did an EEG awake and 95816 was billed. Insurance is denying stating medical records submitted include that EEG was performed. However, the records didn't include recordin... [ Read More ]

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