Appealing Intraoperative EEG/EMG Denials

Question:

I am new to coding for neurosurgery, and we are receiving denials for intraoperative EEG and EMGs; what documentation should we use for appeal?

Answer:

Intraoperative monitoring such as EEG, EMG and SSEP are inclusive to the procedure performed and not separately reported by the operating surgeon or the assistant. (Exception: 95961-26 may be reported when the surgeon performs cortical/subcortical mapping, such as in an awake craniotomy. For denials in these instances, medical necessity and detailed documentation to support the mapping should be sent on appeal)

*This response is based on the best information available as of 12/5/24.