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Frequently Asked Questions

Reimbursement Issues:

1. What CPT Codes are used? 

95950 is the code for 24 hours of eight channels of AEEG. 95953 is the code for 24 hours of 16 or more channels of AEEG. 95951 is commonly used for 24-hour video telemetry when used in conjunction with the EEG.  Please note that there isn’t a flat rate for reimbursement. The amount varies state by state and also varies depending on the insurance carrier.

Please note that effective January 1st, 2011 the description for code 95956 was updated as follows:  
“Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more channel telemetry, electroencephalographic (EEG) recording and interpretation, each 24 hours, attended by a technologist or nurse”

This clearly eliminates it as a code for use with ambulatory EEG.

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2. Can I get reimbursed for spike and seizure detection?

According to the American Clinical Neurophysiology Society (ACNS) spike and seizure detection is included as part of code 95956 and should not be billed separately. Code 95957 is the code for digital analysis of the data and is intended for more in-depth analysis of the EEG. Ultimately, the EEG provider is responsible for contracting with insurance carriers.

Clinical / Practical Questions:

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1. What are the typical clinical indications for use?

As stated in the paper, Ambulatory EEG in the New Millennium, the following indications are given:

  • Documentation of seizure and seizure type, frequency and severity
  • Documentation of sub-clinical seizures
  • Differential diagnosis of seizure vs. syncope
  • Differential diagnosis of seizure vs. pseudo seizure
  • Differential diagnosis of seizure vs. behavior manifestations
  • Differential diagnosis in psychiatric disorders
  • Evaluation of efficacy of anticonvulsant therapy
  • Evaluation of efficacy of ketogenic diet therapy
  • Pre-screening prior to removal from anticonvulsants
  • Pre and post-surgical screening of Vagal Nerve Stimulator™
  • Pre and post-surgical screening for epilepsy surgery

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2. Can I use electrode caps?

No.  Caps are not recommended for AEEG.  They become very uncomfortable for long recordings and the electrodes move, creating problems.  Collodion-applied electrodes is the recommended recording solution. If collodion is not an option, there are methods of applying electrodes with Grass electrode paste, which is very stable after it dries.

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3. How many electrodes are needed to be applied?

Sixteen channels of recording are the minimum used today in most labs.  In addition to these, the Trackit requires that you apply two additional electrodes, a reference and a neutral (ground), so in all there will be a minimum of 18 electrodes. 

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4. What type of electrodes does the system use?

Trackit uses standard 1.5mm, touch-proof, safety electrodes.  These can be purchased from any source.  Some brands, the yellow connector Grass electrodes for example, are too loose for practical purposes. 

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5. How should an adult wear the device?

The unit should be placed in the secure adult pouch and can be worn one of three ways: using the thin shoulder strap, attached to the patient's belt using the loop on the pouch, or attached to the supplied waist and shoulder harness.  The harness can be adjusted for fit and works best when worn like a crossing guard band. 

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6. Can Trackit be used for PSG (Sleep Studies)?

The Trackit may be optimized for PSG applications, including bipolar inputs that can be used to record from transducers such as respiration belts. In addition, Trackit can support O2 saturation and a number of other non-cephalic devices. 

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7. Which review solution do you recommend?

iEEG Review is our recommended cloud-based solution that brings you review, pruning, report generation, and storage capabilities in a single solution. Trackit data can also be read by a number of EEG reader packages, such as Persyst. 

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8. Do I have to review the data myself?

With the cloud-based iEEG Review package, your reviewers can be anywhere in the world. You can securely upload your data to the cloud, and it can be read from anywhere with an internet connection. 

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9. Is the iEEG Review solution secure?

Yes. iEEG is very safe and secure. Lifelines’ undertakes rigorous safety and security testing. The security features incorporated into the iEEG Review solution include advanced encryption, log-in and password protocols, to name a few, and the Lifelines iEEG cloud servers are hosted with secure HIPAA compliant hosting providers. 

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10. Do I have to keep the complete record for archive purposes?

It is very common to sub-sample (purge) the data and only keep the sections that contain interesting events or abnormalities.  iEEG archive services are available to safely and securely share your EEG data for up to 20 years, which complies with virtually all state requirements.

Technical Questions:

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1. What are the benefits of removable media in the Trackit solutions?

Trackit uses a removable flash card that can be swapped very quickly, allowing the Trackit to be put back into service quickly.  This makes the device more productive.  In addition, the system can be upgraded by simply purchasing a larger flash card. Another benefit is that the data can be read via the PC as soon as the flash card has been placed in the card reader.  In this case, there is no download time for the Trackit recorder.  If you wish to transfer the file from the card to the PC, then the transfer time will depend on the speed of the hardware.  An external USB1 card reader takes about 20 minutes for a 24-hour recording. 

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2. Can I use rechargeable batteries?

You can, but we don’t recommend them. They cannot record anywhere near as long as the lithium batteries, and they degrade over time.  It takes three rechargeable 9V batteries to record a 24 hour ambulatory EEG without video; three lithium ion batteries will record up to 72 hours.

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3. What reader packages can read Trackit data?

The following are the primary reading software packages which can read the Trackit files:

  • iEEG
  • Persyst Insight
  • Nervus Reader
  • Stellate Harmonie
  • Oxford Valor
  • Nihon Khoden
  • Viasys Nicolet nEEG reader
  • Neurotronics Polysmith
  • Grass

Several other packages have been shown to work very well with the Trackit files with some limitations in the ability to read the Trackit event marks.

  • NPB Sandman
  • Compumedics Profusion

The data can also be read by some of the main research programs on the market

  • MatLab
  • EEG View
  • Many EDF viewers 

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4. What do existing users like about the system?

  • High-quality recorded signal
  • Recordings up to 72 hours without battery or memory card changes
  • Uses standard electrodes
  • Secure and virtually tamper-proof
  • Extremely reliable
  • Lifelines’ ‘Client First’ service and support  

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5. What are the key features and benefits of the Trackit MK3?

EEG service providers, pharma researchers, physicians, hospital clinicians and veterinarians especially like the Trackit MK3’s ease of use and multiple features. The following are mentioned routinely as favorite features and benefits:

  • 96 hours of continuous recording without battery change
  • Simple-to-use wizard to guide you through recording process
  • Battery backup protects your data

Discover the full list of features and benefits on the Trackit MK3 product page. Click here.

 

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