As we all know health care changes over time and so do these codes. New editions of the CPT codes are updated each October. The CPT code 95951 is the code that monitors localization of cerebral seizure by radio or cable. It is combined electroencephalographic (EEG) to differentiate epileptic different types of epileptic events. The job of the video and EEG is to change an uncertain diagnosis for seizure surgery. The EEG will also be used by video recording interpretation each 24 hours.
Normally the patient will be monitored by the physician by at least 15 to 30 hours but no more than that. If the services are less than nine hours an alternate code will be needed. Most likely the code that would be used for less than nine hours is 95813. This is an EEG extended monitoring code which is greater than one hour. For services of nine to 15 hours what one should report is 95951 with the modifier of code-52. This is a reduced services code. This means that it will indicate that the doctor or neurologist reduced the services that are described by the CPT. The billing of CPT code 95951 is once each 24-hour period.
Most likely the billing service will request the code in order to see the number of hours of monitoring. Sometimes a requirement of who are the payers, which billing company, insurance is necessary. Unlike other codes in the CPT description, there is not always a report necessary to bill the code. Most carriers allow full payment for CPT code 95951.
For any questions it is best to ask your insurer. They will be able to and assist in reporting any CPT codes. Sometimes an insurer will tell you that you are able to report a 95951 code for a time limit more than the given number of hours. Although the insurer might say this, make sure to get it in writing. Anything that is spoken without a written contract means nothing. This especially refers to an insurer saying it is okay to bill the code for services less than nine hours.