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CPT 95700 series/EEG Medicare fee schedule, Global vs Tech

Joshua Posted Thu 02nd of July, 2020 10:41:33 AM
This code has some MACs splitting with PRO and Tech reimbursement, while others only list a Global reimbursement. Is there a Fee schedule for WPS/NGS? Can you advise what the Medicare rate would be for Kansas for these new EEG codes. These new codes are causing a little confusion as to when to bill for Professional vs Technical (CPT 95705, 95707, etc.) Please advise as to whether you need more information/EEG CPTs in question. Thanks!
SuperCoder Answered Fri 03rd of July, 2020 06:50:36 AM

Hi,

 

CPT 2020 adds 95700-95716 for the technical component and 95717-95726 for the professional component. As per WPS, there is no fee schedule for technical component codes i.e. 95700-95716. But WPS provides fee schedule for codes 95717-95726 (professional component).

For WPS fee schedule, please check the below link:

https://www.wpsgha.com/wps/portal/mac/site/fees-and-reimbursements/guides-and-resources/2020-mpfs/!ut/p/z1/jVFBboMwEHxLDxxht6AglJtbJSERKL0kdX2pnMQYIrCRbYLU18dSTpFayt52NTM7mgEGFJjit0Zy12jFW79_sfT7I8_T_DXDYh-XiKRcH5NVVrxtSQqfE4AENwmwOXz8YwjO408A2LT87r8HPoHYlO-lBNZzV4eNqjRQOTQXYUOuLqERVg_mLCzQGGMMu76y3habEH4EM8OabPXp0QJRpyTzHoyohBEmGow_1871dhlggOM4RlJr2YrorLsAf6PU2jqgz0jou8OB_hQ5XhftrSAvdxhjcPI!/dz/d5/L2dBISEvZ0FBIS9nQSEh/

 

Technical: The first technical code, 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), represents setup and the other services listed in the descriptor: Don’t miss the requirement that an EEG technologist is the one performing the service.

There are two situations in which your provider might use these EEGs.

These patients are typically admitted to an epilepsy monitoring unit for long-term EEG monitoring at a nationally accredited epilepsy center, or they can undergo testing in the ambulatory setting by a contracted vendor that performs these in-home studies. “The application involves affixing electrodes with collodion or other substrate that creates a hardened, castlike substance to ensure that the electrodes stay on for the length of the testing.”

The other technical codes (95705-95716) represent monitoring, maintenance, data review, and creation of a technical summary. Choose from the codes based on these elements in the documentation:

  • Use of diagnostic video recorded simultaneously with the EEG (also called video EEG or VEEG).
  • Nature of the technologist’s monitoring: unmonitored, intermittently monitored, continuously monitored.

Professional: These are the factors you’ll need to know for coding the professional interpretation of EEG (95717-95726):

  • Length of the recording the physician or other qualified healthcare professional (QHP) interprets.
  • The timing of report generation by the physician or QHP (daily or after the study is complete).

 

Please check the below links for better understanding:

https://www.supercoder.com/coding-newsletters/my-pain-management-coding-alert/cpt-2020-rev-up-eegveeg-coding-smarts-to-start-year-right-162844-article

 

https://www.supercoder.com/coding-newsletters/my-neurosurgery-coding-alert/cpt-2020-updates-part-1-check-out-23-new-eeg-and-veeg-codes-before-jan-1-rolls-around-162292-article

 

Note: If you don’t have the access of above links, please let us know so that we can provide you complete data.

 

Hope this helps. Please feel free to write if you have any question.

 

Thanks

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