LCD Reference Article Billing and Coding Article

Billing and Coding: eVox® System and Other Electroencephalograph Testing for Memory Loss

A56440

Expand All | Collapse All
Draft Article
Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.
NOT AN LCD REFERENCE ARTICLE
This article is not in direct support of an LCD.

Document Note

Note History

Contractor Information

Article Information

General Information

Source Article ID
N/A
Article ID
A56440
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: eVox® System and Other Electroencephalograph Testing for Memory Loss
Article Type
Billing and Coding
Original Effective Date
04/04/2019
Revision Effective Date
12/14/2023
Revision Ending Date
N/A
Retirement Date
N/A

CPT codes, descriptions, and other data only are copyright 2023 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Current Dental Terminology © 2023 American Dental Association. All rights reserved.

Copyright © 2024, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the AHA copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB‐04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution, or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816.

Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are not endorsed by the AHA or any of its affiliates.

CMS National Coverage Policy

Social Security Act (Title XVIII) Standard References:

  • Title XVIII of the Social Security Act, Section 1833(e) states that no payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period.

Article Guidance

Article Text


eVox®, BrainView NeuralScan and VoxNeuro are Class II medical devices cleared by the U.S. Food & Drug Administration (FDA) that acquire, display, and store the electrical activity of a patient’s brain, including electroencephalograph (EEG) and event-related potentials (ERPs), by placing two or more electrodes on the head. These devices map areas of the brain and measure brain activity. Using analytical software the test findings are placed into interpretable results assisting the physician in making a diagnosis and decision about a patient’s brain function.

Novitas has seen the eVox® System billed to Medicare using the following Current Procedural Terminology (CPT) codes 92650, 92653, 95816, 95930, 95957 and 96146.

Coding Guidance

CPT codes 92650, 92653, 95816, 95930, 95957 and 96146 represent separate services for digital analysis of EEG, EEG recording, and visual and auditory evoked potential testing. The eVox® System and similar tests describe a panel of tests that should be billed using the unlisted neurological or neuromuscular diagnostic procedure code. The panel of tests does not accurately reflect the testing, the work units nor the inherent training described by the CPT codes listed above. Therefore, it is incorrect coding to bill the individual CPT codes listed above when performing the eVox® System or other electroencephalograph testing for memory loss.

When billing for eVox® System, BrainView NeuralScan, VoxNeuro or similar systems CPT code 95999 should be reported on the claim with one unit of service. The term for the device (e.g., eVox® System, BrainView Neural Scan System, VoxNeuro, etc.) should be reported in the Remarks area of the claim for Part A and the Narrative area of the claim for Part B.

Documentation Requirements

  1. All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
  2. Every page of the record must be legible and include appropriate patient identification information (e.g., complete name, dates of service[s]). The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the care to the patient.
  3. The submitted medical record must support the use of the selected ICD-10-CM code(s). The submitted CPT/HCPCS code must describe the service performed.

Response To Comments

Number Comment Response
1
N/A

Coding Information

Bill Type Codes

Code Description

Please accept the License to see the codes.

N/A

Revenue Codes

Code Description

Please accept the License to see the codes.

N/A

CPT/HCPCS Codes

Please accept the License to see the codes.

N/A

CPT/HCPCS Modifiers

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

ICD-10-CM Codes that Support Medical Necessity

Group 1

(1 Code)
Group 1 Paragraph


N/A

Group 1 Codes
Code Description
XX000 Not Applicable
N/A

ICD-10-CM Codes that DO NOT Support Medical Necessity

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

ICD-10-PCS Codes

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

Additional ICD-10 Information

N/A

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

Code Description

Please accept the License to see the codes.

N/A

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

Code Description

Please accept the License to see the codes.

N/A

Other Coding Information

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
N/A N/A
N/A
Non-Excluded CPT/HCPCS Ended Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
N/A

Revision History Information

Revision History Date Revision History Number Revision History Explanation
12/14/2023 R7

Article revised and published on 12/14/2023. After further analysis, it was determined that COGNISION™ does not belong in the article therefore it has been removed.

09/28/2023 R6

Article revised and published on 09/28/2023 to add reference to the VoxNeuro system. 

01/01/2023 R5

Article revised and published on 01/26/2023 effective for dates of service on and after 01/01/2023 to reflect the Annual HCPCS/CPT Code Updates. For the following CPT code either the short description and/or the long description was changed. Depending on which description is used in this article, there may not be any change in how the code displays: 95999 in Group 1 Codes.

01/01/2021 R4

Article revised and published on 11/17/2022 to make a minor clarification in response to an inquiry. The word ‘approved’ was changed to ‘cleared’ with the FDA statement in the first sentence of the ‘Article Text’ section.

01/01/2021 R3

Article revised and published on 05/05/2022 to include additional instruction for correct coding for the eVox® system and similar devices.

01/01/2021 R2

Article revised and published on 02/11/2021 effective for dates of service on or after 01/01/2021 due to the annual CPT code updates. CPT code 92585 has been deleted. In addition, minor formatting changes have been made throughout the article. Documentation requirements have been added. Title XVIII of the Social Security Act, Section 1833(e) has been added under CMS National Coverage Policy section.

11/21/2019 R1

Article revised and published on 11/21/2019 consistent with CMS Change Request 10901. Due to system changes, the order of the Coding Section has been revised and new sections for CPT/HCPCS Modifiers and Other Coding Information have been added.

N/A

Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related Local Coverage Documents
N/A
Related National Coverage Documents
N/A
SAD Process URL 1
N/A
SAD Process URL 2
N/A
Statutory Requirements URLs
N/A
Rules and Regulations URLs
N/A
CMS Manual Explanations URLs
N/A
Other URLs
N/A
Public Versions
Updated On Effective Dates Status
12/08/2023 12/14/2023 - N/A Currently in Effect You are here
09/22/2023 09/28/2023 - 12/13/2023 Superseded View
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

Keywords

N/A