ࡱ> [`Zz9  bjbj .Ndd '''8_Ll'%6----uuu%%%%%%%$'*`<%uuuuu<%--HQ%uF--%u%V"#-0^r# %g%0%~#0**##*#@uuuuuuu<%<%uuu%uuuu*uuuuuuuuu :  TIME \@ "MMMM d, yyyy" January 24, 2020 Dear Insert Insurance Company As a neurology practice providing Long-term EEG (LTEEG) monitoring services to your beneficiaries, we would like to take the opportunity to provide an overview of the changes to this code set which took effect January 2020. It would be most helpful if we could receive your information on technical components rates and professional component rates. Long-term EEG monitoring (LTEEG) is the capability of recording EEG over extended periods of time, often accompanied by continuous closed-circuit video observation. LTM is used most frequently in the diagnosis and management of seizures and other seizure-like spells, but also is used in the evaluation of other neurologic disorders. Prolonged EEG monitoring can be used not only in an epilepsy monitoring unit (EMU), but also in intensive care units, emergency departments, and operating rooms. Many events have clinical appearances that resemble epileptic seizures and if not properly diagnosed could lead to inappropriate treatments and potential risk to the patient. In patients with poorly controlled epilepsy, LTM is needed to most closely localize the seizure onset, the course of the seizure, and the frequency of the seizures, which may improve therapeutic control. LTM can decrease the risk of false negative test results (missing a diagnosis). A new coding structure for reporting Long-term EEG monitoring services went into effect January 1, 2020. Existing codes 95950, 95951, 95953, and 95956 will be deleted and 23 new codes will be implemented: 10 new codes for the professional component (physician services) and 13 new codes for the technical component (technologist services). There are no direct 1:1 crosswalk available due to the separation of the professional and technical components. The professional component services are reported for the physician or other qualified health care professional services of reviewing, analyzing, interpreting, and reporting the results of continuous recording EEG/VEEG (EEG with Video). The professional component codes are described in the chart below with descriptions of the coding. Long-term EEG (LTEEG) Professional ServicesDuration of LTEEG Professional Service2 to 12 hours recording Typical 8 hours12 to 26 hours recording Typical 24 hours36 to 60 hours recording Typical 2 Days60 to 84 hours recording Typical 3 DaysGreater than 84 hours recording Typical 4 DaysRecording typeReports are generated daily; physician access to data throughout recordingEntire report is retroactively generated; physician access to data at end of recordingEEG alone9571795719*957219572395725EEG w/VIDEO9571895720*957229572495726*95719 and 95720 are reported for each 24-hour recording period.Additional units are reported for each 24-hour period.The technical component (TC) codes include 95700 (reported for the set-up, take-down, and patient/caregiver education) and 9570595716 (reported for the monitoring, maintenance, review of data and technical summary). 9570595716 are further differentiated by: Length of recording Level of monitoring (unmonitored, intermittent, or continuous) In the Centers for Medicare & Medicaid Services (CMS) 2020 Final Rule, Medicare assigned contractor pricing for the TC code set 95700, 9570595716. We would appreciate the opportunity to speak with you to understand your rate determinations for the new code set and ensure correct claims submission. Long-term EEG Technical ServicesDuration of LTEEGEEG/VEEG Recording Type95700 (1) Set-up code billed set-up includes take-downUnmonitored Or 13+ patients monitoredIntermittent Up to 12 patients monitoredContinuous Up to 4 patients monitored2 to 12 hours recording Typical service is 8 hoursEEG alone957059570695707EEG w/VIDEO95711957129571312 to 26 hours recording Typical service is 24 hoursEEG alone957089570995710EEG w/VIDEO957149571595716 The technical component includes the provision of all equipment, supplies, personnel, and costs related to the performance of the exam. This can include, but are not limited to EEG technologist (unmonitored, intermittent monitoring or continuous) monitoring, EEG equipment, and set-up. Descriptions of each of these technical components are found below. An EEG technologist is an individual who is qualified by education, training, licensure/certification/regulation (when applicable) in seizure recognition. An EEG technologist preforms EEG set-up, take down, patient education, technical description, maintenance and seizure recognition when within his/her scope of practice and as allowed by law, regulation, and facility policy. Unmonitored services have no real-time monitoring by an EEG technologist during the continuous recording. If the criteria for intermittent or continuous monitoring is not met, then the study is an unmonitored study. Intermittent monitoring requires an EEG technologist to perform and document real-time review of data at least every two hours during an entire recording period to assure the integrity and quality of the recording, identify the need for maintenance, and, when necessary, notify the physician or other qualified health care professional of clinical issues. For intermittent monitoring, a single EEG technologist may monitor a maximum of 12 patients concurrently. If the number of intermittently monitored patients exceeds 12, then all of the studies are reported as unmonitored. Continuous real-time monitoring includes all of the elements of intermittent monitoring. In addition, the EEG technologist performs and documents real-time concurrent monitoring of the EEG data and video (when available) during the entire recording period. The EEG technologist identifies when events occur and notifies, as instructed, the physician or other qualified health care professional. For continuous monitoring, a single EEG technologist may monitor a maximum of four patients concurrently. Thank you for your attention to the contents of this letter. Please contact INSERT CONTACT, by email at INSERT EMAIL or by phone at INSERT PHONE if you have questions or require further information about any of these topics. We look forward to hearing back from you. 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