CPT® Code 95726

Official Description

Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of EEG recording, with video (VEEG)

Common Language Description

The CPT® Code 95726 refers to a comprehensive procedure known as a continuous electroencephalogram (EEG) recording that lasts for more than 84 hours. This procedure is crucial for capturing and analyzing brain wave activity over an extended period, allowing healthcare professionals to monitor and interpret neurological events such as seizures. The continuous recording is often accompanied by video monitoring (VEEG), which enables the physician or qualified healthcare professional to observe the patient's brain activity in real-time, particularly during seizure episodes. This dual approach enhances the accuracy of the diagnosis by correlating the electrical activity of the brain with observable physical manifestations. The procedure is essential for diagnosing various seizure disorders, determining the specific type and location of seizures, and evaluating the effectiveness of ongoing treatments. Additionally, it can help identify new neurological changes in seriously ill patients. The professional component of this service includes a thorough review of the recorded EEG data, an analysis of spike and seizure detection, and the generation of a comprehensive summary report that encapsulates the findings and recommendations based on the recorded events. This detailed interpretation is vital for guiding further treatment decisions and potential surgical interventions for epilepsy management.

1. Indications

The continuous electroencephalogram (EEG) procedure, represented by CPT® Code 95726, is indicated for several specific clinical scenarios, including:

Seizure Disorders The procedure is performed to diagnose the specific type and location of seizures in patients suspected of having epilepsy or other seizure disorders.
Monitoring Treatment It is utilized to monitor the effectiveness of current treatment regimens for epilepsy, allowing for adjustments based on the patient's response.
Distinguishing Conditions The EEG can help differentiate between seizure disorders and other neurological abnormalities that may present with similar symptoms.
Surgical Evaluation In cases where surgical intervention for epilepsy is being considered, this extended EEG service aids in determining the feasibility and potential success of such procedures.
Neurological Changes For seriously ill patients, the procedure may be employed to screen for new or adverse neurological changes that could impact their treatment and care.

2. Procedure

The procedure for CPT® Code 95726 involves several critical steps to ensure accurate and comprehensive EEG recording and analysis:

Preparation of the Patient The patient is prepared for the EEG by having electrodes placed on the scalp to measure electrical activity in the brain. This preparation is crucial for obtaining high-quality recordings.
Continuous Recording The EEG is continuously recorded for a duration exceeding 84 hours. This extended recording period allows for the capture of various brain wave patterns and events, particularly during seizure episodes.
Video Monitoring Concurrently, video monitoring (VEEG) is conducted, where the patient is observed on a video screen for at least 80% of the recording time. This allows the healthcare professional to correlate the EEG data with the patient's physical behavior during seizures.
Data Review After the recording period, a physician or qualified healthcare professional reviews the recorded EEG data. This review includes an analysis of spikes, seizure detection, and other significant brain activity events.
Interpretation and Reporting The professional provides a comprehensive summary report that includes a diagnostic interpretation of the recorded results, recommendations based on the findings, and any necessary follow-up actions.

3. Post-Procedure

Post-procedure care following the continuous EEG recording involves several considerations. Patients may experience some discomfort from the electrodes or adhesive used during the procedure, but this typically resolves quickly. The physician will review the EEG data and video recordings to provide a detailed interpretation, which will be discussed with the patient and their family. Follow-up appointments may be scheduled to discuss the findings and any necessary adjustments to treatment plans based on the results. Additionally, if any new neurological changes are detected, further diagnostic testing or interventions may be recommended to address these issues.

Short Descr	EEG PHY/QHP>84 HR W/VEEG
Medium Descr	EEG COMPLETE STD PHYS/QHP>84 HR W/VEEG
Long Descr	Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of EEG recording, with video (VEEG)
Status Code	Active Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Items and Services Not Billable to the MAC
Type of Service (TOS)	1 - Medical Care
Berenson-Eggers TOS (BETOS)	none
MUE	1

59	Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
AQ	Physician providing a service in an unlisted health professional shortage area (hpsa)
CR	Catastrophe/disaster related
GC	This service has been performed in part by a resident under the direction of a teaching physician
GV	Attending physician not employed or paid under arrangement by the patient's hospice provider
GW	Service not related to the hospice patient's terminal condition