Tools & Resources
Know These 2019 CPT Coding Changes Affecting Neurology The following is a summary of major CPT coding changes affecting neurology in 2019. To learn more about these changes and how they will impact AAN members, attend the free webinar on December 4, E/M and QPP Changes for 2019. Register for the webinar or view the recording at AAN.com/view/Webinar2019.
Electrocorticography Effective January 2019, neurologists will be able to report new code 95836 for the ongoing recording and interpretation of electrocorticography (ECoG) from electrodes chronically implanted on or within the brain. Surgically implanted electrodes allow for intracranial recordings to continue after the patient has been discharged from the hospital. Code 95836 includes unattended ECoG recording with storage for later review and interpretation during a single 30-day period and may be reported only once for each 30-day period. The specific dates encompassed by the 30-day period must be documented in the written report. •95836 Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter, including recording, with interpretation and written report, up to 30 days
Neurostimulators, Analysis-Programming 2019 brings significant changes to neurostimulator analysis and programming CPT codes. Changes to existing CPT codes 95970, 95971, and 95972 are editorial. Existing CPT codes 95974, 95975, 95978, and 95979 will be deleted and replaced with four news codes. These changes include: Clarify reporting of cranial nerve, spinal, peripheral nerve, sacral nerve, and brain neurostimulator services Revise CPT guidelines to define neurostimulator programming and analysis services, acknowledging the work associated with programming may or may not result in any change of the final programming parameters Add language to specify anatomy within the codes Add definitions and anatomical explanations to the guidelines that provide insight regarding the nervous system components being treated, and the granularity in reporting mechanisms for each nervous system component
Revised codes: ▲95970 Electronic analysis of implanted neurostimulator pulse generator/transmitter (e.g., contact group[s], interleaving, amplitude, pulse width, frequency [Hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop parameters, and passive parameters) by physician or other qualified health care professional; with brain, cranial nerve, spinal cord, peripheral nerve, or sacral nerve, neurostimulator pulse generator/transmitter, without programming
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AANnews • December 2018
▲95971 with simple spinal cord or peripheral nerve (e.g., sacral nerve) neurostimulator pulse generator/ transmitter programming by physician or other qualified health care professional ▲95972 with complex spinal cord or peripheral nerve (e.g., sacral nerve) neurostimulator pulse generator/ transmitter programming by physician or other qualified health care professional (95974, 95975 have been deleted. To report, see 95976, 95977) (95978, 95979 have been deleted. To report, see 95983, 95984) New codes: Cranial nerve neurostimulator programming codes are no longer based on time; rather, they are differentiated by simple or complex: Simple programming of a neurostimulator pulse generator/transmitter includes adjustment of one to three parameter(s). Complex programming includes adjustment of more than three parameters. •95976 with simple cranial nerve neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional •95977 with complex cranial nerve neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional Brain neurostimulator programming codes are reported according to the face-to-face time, differentiated by the initial 15 minutes and each additional 15-minute increment of time. •95983 with brain neurostimulator pulse generator/transmitter programming, first 15 minutes face-to-face time with physician or other qualified health care professional •+95984 with brain neurostimulator pulse generator/ transmitter programming, each additional 15 minutes face-to-face time with physician or other qualified health care professional (List separately in addition to code for primary procedure) + = Add on code • = New code ▲ = Revised code
“2019 will bring some notable changes in how neurologists bill for the work of analyzing and programming neurostimulators, including vagus nerve stimulation for the treatment of epilepsy and deep brain stimulation for the treatment of Parkinson disease and other movement disorders” said Bruce H. Cohen, MD, FAAN, chair of the AAN’s Coding Subcommittee and AAN Advisor to the AMA CPT Editorial Panel. “The restructuring of these codes is the result of the ongoing review of CPT codes