Medicare Compliance & Reimbursement - 2013 Issue 41
Reader Question: Awake' or 'Asleep' Distinguishes 95816 From 95819
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Article Overview
This reader Q&A addresses a facility-based EEG billing scenario for neurology professionals and coders. It discusses the general distinction between professional component billing and EEG procedure selection, with emphasis on how the testing context affects reporting. The article is relevant to those working with CPT coding for diagnostic neurological services and related claim reporting.
Why This Topic Matters
Correct EEG reporting affects claim accuracy and how diagnostic interpretation services are billed in facility settings. The article helps coders and neurologists understand the broad factors that determine which EEG code family is being discussed and when professional component billing is involved.
What You Will Learn
- How EEG interpretation services are discussed in a facility billing context.
- The general factors that separate common EEG procedure reporting options.
- Why professional component billing may be part of EEG claim reporting discussions.
- How diagnostic test setting and patient state are presented as relevant topics for code selection.
Who Should Read This
- Medical coders
- Neurologists
- Billing staff
- Revenue cycle professionals
- Compliance staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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