How To Use CPT Code 95954

CPT 95954 describes the use of pharmacological or physical activation during electroencephalogram (EEG) recording, requiring the attendance of a physician or other qualified healthcare professional. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 95954?

CPT 95954 can be used to describe the procedure in which a provider uses a drug or physical activity to stimulate a patient during EEG recording. This code requires the attendance of a physician or other qualified healthcare professional during the activation phase of the EEG recording.

2. Official Description

The official description of CPT code 95954 is: ‘Pharmacological or physical activation requiring physician or other qualified healthcare professional attendance during EEG recording of activation phase (e.g., thiopental activation test).’ This code is used when the provider uses a drug or physical activity to stimulate the patient during EEG recording, with the presence of a physician or other qualified healthcare professional.

3. Procedure

1. During the EEG recording, the provider administers a drug or performs a physical activity to stimulate the patient.
2. The provider attends to the patient throughout the activation phase of the EEG recording.
3. If using a drug like thiopental, the provider injects it into the patient’s bloodstream during the EEG recording.
4. The drug or physical activity causes changes in brain activity, allowing the provider to identify or localize abnormal brain tissue activity.
5. The provider records the EEG during the activation phase and analyzes the results.
6. This procedure helps in identifying and localizing the seizure-generating area of the brain before surgery for epilepsy.

4. Qualifying circumstances

CPT 95954 is used when a physician or other qualified healthcare professional attends to the patient during the EEG recording’s activation phase. This procedure is typically performed to identify or localize abnormal brain tissue activity in patients with epilepsy. The provider may use a drug like thiopental or perform physical activities to stimulate the patient during the recording.

5. When to use CPT code 95954

CPT code 95954 should be used when a physician or other qualified healthcare professional attends to the patient during the EEG recording’s activation phase. This code is appropriate when pharmacological or physical activation is required to stimulate the patient, and the provider is present throughout the recording.

6. Documentation requirements

To support a claim for CPT 95954, the provider must document the following information:

• Reason for performing the EEG recording with pharmacological or physical activation
• Details of the drug or physical activity used for activation
• Date and duration of the EEG recording
• Presence of the physician or other qualified healthcare professional during the activation phase
• Analysis and interpretation of the EEG results
• Signature of the attending physician or qualified healthcare professional

7. Billing guidelines

When billing for CPT 95954, ensure that the procedure is performed with the attendance of a physician or other qualified healthcare professional during the EEG recording’s activation phase. If reporting only the professional component, append modifier 26 to the code. If reporting only the technical component, append modifier TC to the code, unless the hospital provided the technical component. Do not append modifiers if reporting a global service where one provider renders both the professional and technical components.

8. Historical information

CPT 95954 was added to the Current Procedural Terminology system on January 1, 1990. The code’s description was updated on January 1, 2013, to include the requirement of physician attendance during the EEG recording’s activation phase.

9. Examples

1. A neurologist attending to a patient during EEG recording with pharmacological activation using thiopental.
2. A pediatrician performing physical activities to stimulate a child during EEG recording’s activation phase.
3. An epileptologist administering a drug to stimulate a patient with epilepsy during EEG recording.
4. A neurosurgeon attending to a patient during EEG recording with physical activation exercises.
5. A neurophysiologist using a drug to stimulate a patient’s brain activity during EEG recording for surgical planning.
6. A psychiatrist attending to a patient during EEG recording with pharmacological activation to assess brain function.
7. A neurology resident performing physical activities to stimulate a patient during EEG recording’s activation phase under the supervision of an attending physician.
8. A clinical researcher using a drug to activate specific brain regions during EEG recording for a study on brain activity.
9. An anesthesiologist administering a drug to stimulate brain activity during EEG recording for monitoring purposes during surgery.
10. A neuropsychologist attending to a patient during EEG recording with physical activation tasks to assess cognitive function.