From the Research
The ICD-10 codes to be used for CPT code 95819 depend on the medical condition necessitating the EEG, and appropriate diagnoses might include G40.xx series for epilepsy and seizure disorders, R56.9 for unspecified convulsions, R40.xx for altered mental status, G47.xx for sleep disorders, R51 for headache, F44.5 for conversion disorder with seizures, and R55 for syncope and collapse 1, 2, 3, 4, 5. The specific code selection should match the patient's documented symptoms or condition that medically justifies the EEG procedure.
- For example, if ordering an EEG for a patient with generalized idiopathic epilepsy, G40.309 would be appropriate.
- Insurance reimbursement for 95819 requires medical necessity supported by these diagnosis codes, and using symptom codes like R56.9 (unspecified convulsions) may be appropriate when a definitive diagnosis hasn't been established but the patient has symptoms warranting EEG evaluation. The provided evidence does not directly address the ICD-10 codes for CPT code 95819, but it discusses the diagnosis and treatment of carpal tunnel syndrome, which is not directly related to the question. However, the evidence suggests that nerve conduction studies and EMG can be useful in diagnosing carpal tunnel syndrome 1, 2, 3, 4, 5. In the context of CPT code 95819, the focus is on EEG procedures, and the relevant ICD-10 codes should be selected based on the patient's condition and symptoms. It is essential to choose the correct ICD-10 codes to ensure accurate billing and reimbursement for the EEG procedure. The most recent and highest quality study on this topic is not directly available, but the provided evidence suggests that the selection of ICD-10 codes should be based on the patient's medical condition and symptoms 1.