Services at the Hospital

September 1, 2008

We will be establishing an EMU at our hospital and we are confused as to which CPT code to bill and how it will be paid. We will be performing 16-channel EEG with video recording and interpretation over a 24-hour period. Will payment be calculated by DRG pricing?

Question: We will be establishing an EMU at our hospital and we are confused as to which CPT code to bill and how it will be paid. We will be performing 16-channel EEG with video recording and interpretation over a 24-hour period. Will payment be calculated by DRG pricing?

Answer: Look at CPT codes series 95950–95956. You’d have to determine if they suit exactly what you are doing. I also highly recommend speaking to the manufacturer of the machine. They can usually tell you all about the coding.

As far as whether this will be a DRG or CPT service, you need to chat with the hospital, as every case is different. Presumably, this is some kind of joint deal with the hospital and someone must have figured out in advance how the billing is going to happen, particularly what the place of service is to be for different payers; you just need to find the right person.

If no one did think about this in advance, you’ll need to craft the deal.