Coding Tip
Codes
95961 and
95962 may be reported with codes
95700-
95726 when functional cortical or subcortical mapping is performed with long-term EEG monitoring.
EEG Monitoring: Professional Component (PC) Services (
95717-
95726)
Codes
95717-
95726 describe the professional services performed by a physician or other qualified health care professional (QHP) for reviewing, analyzing, interpreting, and reporting the results of the continuous recording EEG/VEEG with recommendations based on the findings of the studies. These codes do not include evaluation and management (E/M) services, which may be reported separately. The selection of a PC code is based on (1) length of the recording being interpreted and (2) when the report(s) by a physician or other QHP are generated (ie, whether diagnostic interpretations and reports are made daily during the study or whether the entire professional interpretation is performed only after the full study is completed). Codes
95717-
95720 are reported when daily professional reports are generated during the long-term recording, even if the entire study extends over multiple days, or when the time of recording for the entire study is between 2 hours and 36 hours. Codes
95717 and
95718 are reported once for a 2-12 hour recording and are reported a maximum of once for an entire long-term EEG service if the study extends over multiple days. Codes
95719 and
95720 are reported once each day for each 24 hours of a multiple day recording and reported once for a single recording greater than 12 hours up to 26 hours. The recorded data are reviewed, interpreted, and reported daily by the physician or other QHP, and summary reports are made for the entire multiple-day study at the end of the recording period.
Codes
95705-
95707,
95711-
95713 may only be reported once for the complete EEG service, either for the initial 2-12 hours or for the final 2-12-hour increment when an EEG service that extends beyond 26 hours. Codes
95711-
95716 are reported when diagnostic video of the patient is recorded a minimum of 80% of the time, concurrent with diagnostic EEG recording (ie, the entire study is reported as an EEG without video if the length of the concurrent diagnostic video recording is less than 80% of the entire diagnostic EEG recording). Table 1 provides a conceptual framework for reporting the TC of EEG services based on the diagnostic recording time.
For a more comprehensive table of how to report long-term EEG monitoring codes, refer to the Long-Term EEG Monitoring Table on page 715 of the 2020
CPT Professional Edition codebook. Diagnostic EEG recording is an essential component of all long-term EEG services. If diagnostic EEG recording stops, timing stops until the diagnostic EEG recording is resumed.