2025 CPT code 95813
(Active) Effective Date: N/A Revision Date: N/A Diagnostic - Routine Electroencephalography (EEG) Procedures Neurology and Neuromuscular Procedures Feed
Extended EEG monitoring lasting 61-119 minutes.
Modifier 26 (professional component) may be appended if only the physician's interpretation is reported.Modifier TC (technical component) may be used for the technical component under certain circumstances; refer to guidelines for appropriate modifier use.
Medical necessity for an extended EEG must be documented. This typically involves clinical findings suggesting the need for prolonged monitoring to capture intermittent events, such as suspected epilepsy, or to evaluate complex neurological conditions requiring continuous monitoring.
The provider places electrodes on the patient's scalp and records brain electrical activity for 61-119 minutes. Interpretation and report generation are included.
In simple words: This code covers a longer-than-usual brainwave test (EEG) that lasts from 61 to 119 minutes.Electrodes are placed on the scalp to record brain activity, helping diagnose epilepsy, sleep problems, or other brain conditions.
This CPT code, 95813, reports an extended electroencephalogram (EEG) monitoring lasting between 61 and 119 minutes.The procedure involves placing electrodes on the scalp to record brain electrical activity.It's used to diagnose conditions like epilepsy, sleep disorders, and coma.
Example 1: A patient presents with suspected epilepsy.An extended EEG is performed to capture seizure activity, which may only occur sporadically., A patient in a coma undergoes continuous EEG monitoring to assess brain function and detect any changes., A patient with suspected sleep disorder undergoes a prolonged EEG study to identify any sleep abnormalities or associated brainwave patterns.
* Patient's medical history and reason for the EEG.* Detailed description of the EEG procedure, including electrode placement, recording duration, and any interventions (hyperventilation, photic stimulation).* Physician's interpretation and report of the EEG findings.* Medical necessity documentation justifying the extended recording time.
** The recording time for code 95813 excludes setup and takedown time.If the recording is interrupted, the clock stops until recording resumes.Payers may require additional documentation to support medical necessity.
- Revenue Code: T2D (OTHER TESTS - OTHER)
- Payment Status: Active
- Modifier TC rule: Modifier TC may be appropriate if only the technical component of the service is billed.
- Specialties:Neurology, Clinical Neurophysiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center,Other Place of Service (depending on the clinical setting)