Epilepsy is a chronic non – communicable brain illness. It is distinguished by repeated seizures, which are brief periods of uncontrollable movement involving a portion of the body or the entire body, and is frequently associated with a loss of consciousness and regulation of bowel or bladder function. People with epilepsy are more likely to die 3 times earlier than the overall population. Epilepsy is often diagnosed after at least two seizures not caused by a proven medical condition, such as alcohol withdrawal or dangerously low blood sugar. Neurologists must carefully examine a patient’s medical history and evaluate brain imaging results to analyze irregular patterns of electrical activity in the brain.
Epilepsy Treatment Procedures Using CPT Codes
Neurologists must analyze the severity of the disease and its results to determine the treatment plan. Proper patient care is provided only with an accurate diagnosis. For claims to be reimbursed, the CPT codes related to each procedure must be allocated precisely. Following are the CPT codes to report epilepsy treatment procedures.
CPT code 95819
This code includes routine EEG. EEG stands for Electroencephalogram. It is a diagnostic examination that measures the brain’s electrical activity using small electrodes connected to the scalp. In this technique, the provider performs EEG during the patient’s conscious and sleeping stages.
CPT code 95709
Electroencephalography, a study of the brain’s electrical activity, is performed on the patient for 12 to 26 hours, with occasional monitoring and maintenance. There is no video recording, the data is reviewed, and an EEG technologist writes a technical description.
CPT code 70554
In this diagnosis procedure, the provider does long-term EEG monitoring. The provider uses functional magnetic resonance imaging to measure brain activity by detecting metabolic changes that occur in neural activity.
CPT code 78811
PET (positron emission tomography) is performed on a tiny, specified body area during this diagnostic process. PET is a nuclear imaging test that creates three-dimensional images of functional processes in the body and is an excellent means of finding tumor cells.
ICD-10 Codes for Epilepsy
Following are the ICD-10 codes to report epilepsy:
G40: Epilepsy is written using this code.
G40.11: This ICD-10 code reports idiopathic (focal) (partial) epilepsy and epileptic syndromes with seizures or circumscribed onset, and associated with status epilepticus.
G40.019: This code reports idiopathic (focal) (partial) epilepsy and epileptic syndromes with seizures of localized onset that are intractable and do not result in status epilepticus.
G40.111: It reports localization-related symptomatic epilepsy and epileptic syndromes with intractable simple partial seizures and status epilepticus.
G40.119: It is used to report localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures that are intractable and do not manifest with status epilepticus.
G40.211: This code reports localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with intractable complicated partial seizures and status epilepticus.
G40.219: This code reports localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures that are intractable and do not present with status epilepticus.
G40.3: Idiopathic generalized epilepsy and epileptic syndrome is reported using G40.3
G40.4: Another generalized epilepsy and epileptic disorders are reported using G40.3
G40.5: Special epileptic syndromes are reported using G40.5.
G40.6: Unspecified grand mal seizures (with or without petit mal) are reported using G40.6
G40.7: Petit mal seizures, unspecified; no grand mal seizures are reported using G40.7
G40.8: This code is used to report other types of epilepsy
G40.9: Unspecified epilepsy is reported using G40.9
G41: Status epilepticus is written with the help of code G41
G41.0: This code is used to register Grand mal status epilepticus
G41.1: Physicians report Petit mal status epilepticus using G41.4
G41.2: Complex partial status epilepticus is reported using G41.2
G41.8: Physicians report Other status epilepticus using G41.8
G41.9: Physicians report Status epilepticus, unspecified, using G41.9
An in-depth awareness of current billing and coding principles or practices is required to submit claims for accurate reimbursement. Skilled medical billing and coding firms have a complete grip over coding and billing procedures. Because the diagnosis of epilepsy can have serious legal and personal consequences for the patient, such as the inability to obtain a driver’s license, reputable medical coding service providers will assign an epilepsy code based solely on the condition identified by the physician in the diagnostic statement.