Modifier 59 is used with those procedures to identify that they are separate in time and separate procedures. Those are two separate procedures because they were separated in time. That EEG leads to the patient being placed on continuous monitoring later the same day. For example, an inpatient EEG test might be performed in the morning, and it indicates that the patient is at risk for nonconvulsive seizures.
This code signifies that the two different procedures are separate and both should be coded. Modifier 59 is used to identify when two different procedures in the same family of services are performed on the same day. Because there are at least three different ways to count monitoring, each hospital’s service is highly encouraged to have a written policy in place to describe the particular rules used at their institution and to keep that written policy and procedure available in case of any internal or external audits. The subsequent attending will pick up the monitoring at that point in time. Jones will code without modifier 52 for her 18 h of monitoring service. Jones monitored until change of shift at 9 AM on Wednesday, then Dr. Using this rule, if the patient was hooked up at 3 PM on Tuesday and Dr. If in the course of a 6-day monitoring 2–3 different attending physicians monitored the patient, then the coding is allocated among the attending physicians by the time of change of responsibility. They may use a 24-h clock set to the time of morning change of service, e.g., 9 AM. Take the example of a service that typically changes attending physicians in the morning. Some professionals use other clock time rules, such as the service day rule.
Those companies have yet to update their carrier policies to the modern era of ICU EEG monitoring. The present use of 95813 is for certain insurance companies that have not yet approved the use of 95951 or 95956 but will allow for 95813 for ICU EEG monitoring. This code allows interpretation to be made after the record is completed. Another use of this code is for neonatal EEGs that may take 90 min to record quiet and active sleep and awake state. In the digital era, an analogous procedure is that the record may be reviewed in portions instead of reviewing the entire digital record, i.e., auditing a record. Because it was originally defined during the paper EEG era, the original definition allowed the EEG to be turned on and off at the bedside by the nurse or technologist so as to save paper. It does specify more than 1 h of recording.
One such purpose was as a bedside EEG machine in the early days of ICU EEG monitoring in which the paper recording might last for only 4–8 h during the day. Code 95813 specifies, “extended EEG, greater than 1 h.” This code has several original purposes. Two other EEG codes deserve special mention: codes 9587.