Tips for Successfully BIlling 2-12-Hour EEG CPT Codes
The 2 to 12-hour technical codes, 95705, 95706, 95707 (EEG only) and 95711, 95712, 95713 (EEG +video) have two main use-cases:
- The first use-case is day monitoring, an average of 8 hours, which could be performed in a number of settings, as an extended EEG, such as a neurologist office or outpatient EEG lab.
- The second use-case is as a half-day study. When a multi-day, long-duration EEG does not extend sufficiently for a final complete day, the 2 to 12-hour code is used to capture the partial day. Keep in mind you can only have ONE partial day makeup. The key to compliance is awareness of your facility’s billing period. Many use the 24 hours starting at midnight, but not all. A facility can choose 7 am or assign another time as the start of its 24 hour billing period. Be familiar with your start time and then look at the hours recorded in each billing period.
Example: A facility’s billing period starts at midnight. The patient is hooked up and long-duration EEG begins at 4 pm Monday. It continues over the next 2 nights and disconnects on Wednesday at 8 am.
Day 1 Monday - 8 hours of recording, 4 pm to midnight, use 2-12 hour code.
Day 2 Tuesday - 24 hours of recording, midnight to midnight, use 12-26 hour code.
Day 3 Wednesday - 8 hours of recording midnight to 8 am - use 2-12 hour code. However, you are not allowed to bill two of these codes for one study! What can you do? Either the facility absorbs the loss and provides this last 8 hours for free, or, you extend the recording long enough for a second 12-26 hour code.
This also applies to the physician’s daily professional codes 95717 and 95718, the 2-12 hour read and report code. If you are in a hospital setting, most likely reimbursement is through DRG, but you may well still have to report CPT with proper usage.
This information is provided as a guideline. Please consult with your billing/coding department to determine how to best submit studies for payment.