How To Use CPT Code 95830

CPT 95830 describes the insertion of sphenoidal electrodes by a physician or other qualified healthcare professional for electroencephalographic (EEG) recording. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 95830?

CPT 95830 can be used to describe the insertion of sphenoidal electrodes by a physician or other qualified healthcare professional for EEG recording. This procedure involves the placement of electrodes into the patient’s cheeks to record the brain’s electrical activity through an electroencephalogram.

2. Official Description

The official description of CPT code 95830 is: ‘Insertion by physician or other qualified health care professional of sphenoidal electrodes for electroencephalographic (EEG) recording.’

3. Procedure

1. During the procedure, the physician or qualified healthcare professional applies a topical anesthetic to the patient’s cheeks to minimize discomfort.
2. Using a needle, the healthcare professional inserts sphenoidal electrodes into the cheeks, targeting the sphenoid bone located in front of the temporal bone.
3. After the electrodes are inserted, the needle is withdrawn.
4. The electrodes transmit the brain’s electrical activity to a computer, capturing signals from the frontal and temporal lobes of the brain.

4. Qualifying circumstances

CPT 95830 is performed to diagnose various disorders, including epilepsy. It is typically used when other non-invasive methods of EEG recording are insufficient or inconclusive. The procedure requires the expertise of a physician or other qualified healthcare professional who is trained in the insertion of sphenoidal electrodes.

5. When to use CPT code 95830

CPT code 95830 should be used when a physician or qualified healthcare professional inserts sphenoidal electrodes for EEG recording. It is important to ensure that the procedure is medically necessary and appropriate for the patient’s condition. Other non-invasive methods of EEG recording should be considered before resorting to the insertion of sphenoidal electrodes.

6. Documentation requirements

To support a claim for CPT 95830, the healthcare professional must document the following information:

• The patient’s diagnosis and the medical necessity of the procedure
• The date and time of the procedure
• A detailed description of the procedure, including the use of topical anesthetic and the insertion of sphenoidal electrodes
• The specific location of the electrodes (cheeks) and the targeted sphenoid bone
• Any relevant findings or observations during the procedure
• The signature of the physician or qualified healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 95830, ensure that the procedure is performed by a physician or other qualified healthcare professional. Follow the appropriate coding guidelines and ensure accurate documentation to support the medical necessity of the procedure. It is important to review any specific billing requirements or guidelines from the payer to ensure proper reimbursement.

8. Historical information

CPT 95830 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2013, with the description updated to specify the insertion of sphenoidal electrodes by a physician for EEG recording.

9. Examples

1. A neurologist inserting sphenoidal electrodes for EEG recording to diagnose a patient with suspected epilepsy.
2. A neurosurgeon performing the procedure to gather data for pre-surgical evaluation in a patient with intractable seizures.
3. An epileptologist inserting sphenoidal electrodes to monitor brain activity during a patient’s stay in an epilepsy monitoring unit.
4. A pediatric neurologist using the procedure to assess brain function in a child with developmental delays.
5. A neurophysiologist performing the procedure to evaluate brain activity in a patient with unexplained episodes of altered consciousness.
6. A neurology resident assisting in the insertion of sphenoidal electrodes under the supervision of an attending physician.
7. A neurosurgeon using the procedure to monitor brain activity during awake craniotomy for tumor resection.
8. An epileptologist inserting sphenoidal electrodes to evaluate brain activity in a patient with refractory status epilepticus.
9. A neurologist performing the procedure to assess brain function in a patient with suspected sleep-related disorders.
10. A neurophysiologist using the procedure to evaluate brain activity in a patient with suspected psychogenic non-epileptic seizures.