Billing and Coding: EEG – Ambulatory Monitoring

Ambulatory EEG is covered for diagnostic evaluation of suspected seizures/interictal activity, for pre-surgical localization requiring capture of multiple seizures, and for routine follow-up monitoring. Typical monitoring durations are 48–72 hours for diagnostic and follow-up studies and 7–10 days for pre-surgical evaluations; monitoring beyond 72 hours requires written justification for each additional 24-hour segment. Claims must include a valid ICD-10-CM diagnosis and, when applicable, the referring/ordering physician's name and NPI, and coding is subject to NCCI/OPPS edits.

"Ambulatory EEG is covered for diagnostic evaluation when seeking to detect clinical seizures or interictal epileptiform activity."

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