LaTanya Posted Wed 29th of November, 2017 10:23:52 AM
How should we report an EEG where the monitoring period was 48 hours. CPT 95951 is the code that describes our services, however this code is per 24 hours. There is a MUE of 1 so we can not bill multiple units and appending modifier 76 does not seem appropriate in this case because this would convey that the procedure was performed twice on the same calendar date, which was not the case. And CMS advises that we must report under the date of service when the professional component was performed, and the physician interp was performed at the conclusion of the monitoring period and therefore we can not bill two 95951's under different dates. Should we bill using an unlisted code instead since the existing code is only for 24 hours? Thank you
SuperCoder Answered Thu 30th of November, 2017 01:38:47 AM
How our providers bill, is by the test date. So when this video EEG is done for days in a row, the Dr's interpretation always states the date of the study.
Example: . The interp will say "Study date: December 20th, through December 21st". We bill DOS 12/20. The next day the EEG was done may be 2 days later, and the interp will state "Study date: December 22nd through December 23rd". We bill DOS 12/22. So each EEG report gets billed based on the date that it was performed. Not when it was interpreted.
HOPE THIS HELPS!