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2025 CPT code 95721

Electroencephalogram (EEG), continuous recording, physician review, spike and seizure detection analysis, interpretation, and summary report; >36 hours, ≤60 hours, no video.

Refer to the CPT manual for specific guidelines on long-term EEG coding and the requirements for continuous vs. intermittent monitoring.

Modifiers may be applicable depending on the circumstances, such as modifier 52 for reduced services.

The medical necessity is established by clinical suspicion of epilepsy, non-convulsive status epilepticus, or other neurological conditions where continuous EEG monitoring is needed to obtain adequate diagnostic information. The duration of monitoring should be clinically justified based on the patient's condition and clinical presentation.

Physician or other qualified healthcare professional reviews, interprets, and reports findings from a long-term continuous EEG recording.

IMPORTANT:Codes 95717-95720 are used for daily professional reports during a long-term EEG recording lasting 2-36 hours. Codes 95722-95726 are for complete professional interpretation after the entire study is completed for recordings exceeding 36 hours.Technical components are billed separately using codes 95700-95716.

In simple words: The doctor reviews a long brainwave test (EEG) that ran for more than 36 hours but less than 60 hours.They look for unusual patterns to detect seizures or other problems. The doctor interprets the results and writes a report. This code only covers the doctor's work; the recording of the test is billed separately.

This CPT code encompasses the professional component of a long-term continuous EEG recording lasting more than 36 hours but not exceeding 60 hours, without video.A physician or other qualified healthcare professional reviews the recorded events, analyzes spike and seizure detection, interprets the data, and prepares a comprehensive summary report.This does not include the technical component (EEG recording and setup) which would be billed separately using other codes in the 95700-95716 series.Daily reports are not generated during the study; the final interpretation is performed after the study's completion.

Example 1: A patient with suspected epilepsy undergoes a 48-hour continuous EEG to identify seizure activity and determine its type and location for potential surgical intervention. Code 95721 would be used for the physician's interpretation of the study’s complete results., A patient in the ICU with altered mental status is monitored with continuous EEG for 50 hours. Code 95721 would reflect the physician's comprehensive interpretation done after the recording is complete., A patient with suspected non-convulsive status epilepticus is monitored via continuous EEG for 40 hours to confirm the diagnosis. Code 95721 represents the physician's interpretation of the entire recording after data acquisition.

Complete EEG tracing, physician's interpretation report with findings and recommendations, patient's medical record documenting the reason for the study.

** This code should only be used for complete studies lasting more than 36 hours, up to 60 hours, without video. If video EEG is performed, different codes apply.Proper documentation justifying the length of the study is crucial for reimbursement.

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