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CPT `95957` - Which party files the professional component?

SuperCoder Posted Wed 21st of September, 2011 19:27:10 PM

Under 95957, if the EEG manufacturer provides EEG analytical services, including an analysis/interpretation of the EEG test results, and those analytical services are contracted by the treating physician, the EEG manufacturer would presumably file the "technical" component of 95957. My Question: would the mfr. also file the "professional" component? ..... Also, does the answer change if the analytical services also includes a "diagnosis"?

SuperCoder Answered Wed 21st of September, 2011 21:30:12 PM

It can be a rare scenario and very hypothetical too. For example, if a Manufacturer employes a physician as a salaried employee to provide the analytical services too, then the manufacturer can bill the services as both professional+technical, i.e; can bill global. To bill only as global would be too distant possibility.
The answer would not change if the analytical services include a diagnosis.

SuperCoder Posted Wed 21st of September, 2011 22:30:54 PM

Under 95957, is there such a thing as "Global"? For example, under "Medicare Fees", there is no column for "Global" (unless "National" = "Global"). Also, under "Global & Other Info", "Global Period" is described as "The Global concept does not apply to the code".

SuperCoder Answered Thu 22nd of September, 2011 03:22:28 AM

I am sorry for using the term global here that misled you, it doesn't mean global period here, because the "Global and Other info" not applicable here.
It is a billing vocab when a procedure is billed as professional plus technical combinedly, known as "billing globally". To avoid confusion, you can just interpret it as to bill both professional and technical component combined.

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