How To Use CPT Code 95958

CPT 95958 describes the Wada activation test for hemispheric function, including electroencephalographic (EEG) monitoring. 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 95958?

CPT 95958 can be used to describe the Wada activation test for hemispheric function, which involves injecting anesthetic into the internal carotid artery to study one side of the brain at a time. This test helps determine which side of the brain is responsible for vital cognitive functions such as memory and language. The code also includes electroencephalographic (EEG) monitoring to identify crucial areas of the brain.

2. Official Description

The official description of CPT code 95958 is: ‘Wada activation test for hemispheric function, including electroencephalographic (EEG) monitoring.’

3. Procedure

1. During the Wada activation test, the provider injects anesthetic into either the right or left internal carotid artery.
2. This allows the provider to study one side of the brain at a time to determine its role in vital cognitive functions.
3. Electroencephalographic (EEG) monitoring is performed to identify areas of the brain that are crucial to patient function.

4. Qualifying circumstances

The Wada activation test is typically performed prior to brain surgery, such as ablative surgery for epilepsy or tumor resection surgery. It helps the provider identify which side of the patient’s brain controls language and which side has better memory. This information is crucial for surgical planning and ensuring the preservation of vital brain functions. The test is performed by a qualified healthcare professional who has the necessary expertise in administering the test and interpreting the results.

5. When to use CPT code 95958

CPT code 95958 should be used when the provider performs the Wada activation test for hemispheric function, including EEG monitoring. It is appropriate to use this code when the test is performed prior to brain surgery to determine the functional areas of the brain and ensure the preservation of vital cognitive functions.

6. Documentation requirements

To support a claim for CPT 95958, the provider must document the following information:

• Reason for performing the Wada activation test
• Specific details of the test, including which side of the brain was studied
• Results of the test, including the areas of the brain responsible for language and memory
• Date and duration of the test
• EEG monitoring findings
• Signature of the provider performing the test

7. Billing guidelines

When billing for CPT 95958, ensure that the test is performed by a qualified healthcare professional and includes EEG monitoring. If reporting only the professional component, append modifier 26 to the code. If reporting only the technical component, append modifier TC 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 95958 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A neurologist performing the Wada activation test to determine the language and memory functions of a patient prior to epilepsy surgery.
2. A neurosurgeon administering the Wada activation test to identify the functional areas of the brain before tumor resection surgery.
3. A neuropsychologist conducting the Wada activation test to assess the cognitive functions of a patient with a brain injury.
4. A neurology team performing the Wada activation test to determine the hemispheric function of a patient with a suspected brain tumor.
5. A neurosurgeon utilizing the Wada activation test to map the brain functions of a patient before performing a complex brain surgery.
6. A neurologist performing the Wada activation test to assess the cognitive abilities of a patient with a history of stroke.
7. A neurosurgical team conducting the Wada activation test to identify the language-dominant hemisphere of a patient before epilepsy surgery.
8. A neuropsychiatrist administering the Wada activation test to evaluate the cognitive functions of a patient with a psychiatric disorder.
9. A neurology team utilizing the Wada activation test to determine the memory functions of a patient before performing a brain biopsy.
10. A neurosurgeon performing the Wada activation test to assess the cognitive abilities of a patient with a brain arteriovenous malformation.