95700

Long-term EEG setup, patient education, and knockdown by technologist

CPT 95700 represents the technical component for the initiation and conclusion of long-term electroencephalographic (EEG) monitoring services. This code specifically accounts for the work performed by a qualified healthcare professional or technologist in preparing the patient for a study that exceeds two hours in duration. The process begins with a comprehensive review of the patient's clinical history and the specific goals of the monitoring, such as seizure characterization, localization of an epileptogenic zone, or monitoring for subclinical status epilepticus. The technologist then performs a precise measurement of the patient's scalp using the International 10-20 System or an equivalent standardized method to ensure accurate and reproducible electrode placement. Skin preparation is critical to maintain low impedance, often involving the use of mildly abrasive gels. Electrodes are then secured using conductive paste or specialized adhesives like collodion, which is essential for multi-day recordings to prevent lead displacement during sleep or movement. A significant portion of the work described by CPT 95700 involves patient and caregiver education. The technologist explains the importance of the event marker button, the necessity of maintaining a detailed diary of clinical events, and instructions for navigating the physical constraints of the monitoring equipment. If video is included, the technologist ensures the camera is appropriately positioned and synchronized with the EEG data stream. Finally, the code includes the 'knockdown' or removal of the equipment at the end of the recording period, which involves the careful removal of electrodes, cleaning the scalp of adhesives, and ensuring all data has been successfully captured and stored for physician review. This code is foundational for long-term monitoring, regardless of whether the study is performed in a hospital setting, an epilepsy monitoring unit, or at the patient's home.

Clinical Indications

  • Diagnosis and classification of seizure disorders
  • Localization of the epileptogenic zone for potential surgical intervention
  • Monitoring the effectiveness of anti-epileptic medication titration
  • Distinguishing between epileptic seizures and non-epileptic behavioral spells
  • Evaluation of unexplained episodes of loss of consciousness or altered mental status
  • Assessment for subclinical or non-convulsive status epilepticus in critically ill patients

Procedure Steps

  1. Verification of physician order and patient identification.
  2. Patient and caregiver interview to review clinical history and current medications.
  3. Measurement of the scalp using the International 10-20 System to identify electrode sites.
  4. Preparation of the skin at each electrode site to ensure impedance values are within acceptable limits (usually less than 5 kOhms).
  5. Application of scalp electrodes using conductive paste or collodion adhesive.
  6. Connection of electrodes to the EEG amplifier and verification of signal integrity across all channels.
  7. Synchronization of EEG data with digital video recording if video-EEG is ordered.
  8. Education of the patient on the use of the event marker and maintenance of the event log.
  9. Removal of electrodes and cleaning of the patient's scalp (knockdown) at the conclusion of the recording period.

Coding Guidelines

  • Report 95700 only once per recording period regardless of the total duration of the monitoring.
  • 95700 is intended for long-term monitoring studies that exceed 2 hours in duration.
  • Do not report 95700 in conjunction with routine EEG codes 95812, 95813, 95816, 95819, 95822, or 95827.
  • This code represents the technical setup and teardown only; it does not include the monitoring of the data or the physician's interpretation.
  • For the actual monitoring component, see codes 95705-95716 (technical) or 95717-95726 (professional).
  • If the technologist stays with the patient to provide continuous monitoring, additional monitoring codes should be reported based on the duration and type of monitoring (with or without video).

Associated ICD-10 Codes