tci Outpatient Facility Coding Alert - 2015 Issue 5

Reader's Question: Go Ahead and Bill EEG With Hospital Visit

Question: Medicare denied our bill for an EEG when our physician read one in addition to a hospital visit. Can you please provide guidance for the best coding approach? Florida Subscriber Answer: Yes, you can report an EEG reading with a hospital visit. The NCCI currently has no bundling edits between the electroencephalogram codes and the initial or subsequent hospital care E/M codes. Medicare, however, does cover the diagnostic testing services provided in a facility setting, such as a hospital POS (Place of service) 21, as separate components. Note that the technical component of diagnostic testing is included in...

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