Neurology billing requires mastery of some of the most technically complex diagnostic procedure codes in all of medicine. EEG and VEEG monitoring codes, EMG and nerve conduction study codes, and the 2021 E/M documentation changes all require specialty-specific knowledge that generalist billers frequently lack. Add high prior authorization rates for nearly every diagnostic study, and it becomes clear why neurology practices lose more revenue to billing errors than almost any other specialty.

EEG CPT Codes — Electroencephalography

EEG code selection depends on three variables: the duration of the recording, the patient's state during the recording (awake, drowsy, asleep), and whether video monitoring was concurrent. Getting these variables wrong is one of the most common neurology billing errors.

Routine EEG Codes

• 95816 — EEG, including hyperventilation and/or photic stimulation — awake and drowsy
• 95819 — EEG, including hyperventilation and/or photic stimulation — awake and asleep
• 95822 — EEG — sleep only
• 95824 — EEG — cerebral death evaluation (brain death confirmation)
• 95827 — EEG — all night recording

Long-Term EEG Monitoring (No Video)

• 95705 — Continuous EEG monitoring for 2–12 hours — unmonitored
• 95706 — Continuous EEG monitoring for 2–12 hours — monitored
• 95707 — Continuous EEG monitoring for 2–12 hours — monitored, physician review
• 95708 — Continuous EEG monitoring 12–26 hours — unmonitored
• 95709 — Continuous EEG monitoring 12–26 hours — monitored
• 95710 — Continuous EEG monitoring 12–26 hours — monitored, physician review
• 95711 — Continuous EEG monitoring greater than 36 hours — unmonitored
• 95712 — Continuous EEG monitoring greater than 36 hours — monitored
• 95713 — Continuous EEG monitoring greater than 36 hours — monitored, physician review

Long-Term Video EEG Monitoring (VEEG)

• 95717 — VEEG monitoring 2–12 hours — unmonitored
• 95718 — VEEG monitoring 2–12 hours — monitored
• 95719 — VEEG monitoring 2–12 hours — monitored, physician review
• 95720 — VEEG monitoring 12–26 hours — unmonitored
• 95721 — VEEG monitoring 12–26 hours — monitored
• 95722 — VEEG monitoring 12–26 hours — monitored, physician review
• 95723 — VEEG monitoring 26–36 hours — unmonitored
• 95724 — VEEG monitoring 26–36 hours — monitored
• 95725 — VEEG monitoring 26–36 hours — monitored, physician review
• 95726 — VEEG monitoring greater than 36 hours — monitored, physician review

EMG CPT Codes — Electromyography

EMG and nerve conduction study (NCS) codes are among the most complex in neurology. The number of extremities tested, whether paraspinal muscles are included, and how many individual nerve conduction studies are performed all affect code selection and reimbursement. Payers have strict medical necessity criteria and frequency limits for these studies.

Needle EMG Codes

• 95860 — EMG needle, 1 extremity without paraspinal muscles
• 95861 — EMG needle, 2 extremities without paraspinal muscles
• 95863 — EMG needle, 3 extremities without paraspinal muscles
• 95864 — EMG needle, 4 extremities without paraspinal muscles
• 95867 — EMG needle, cranial nerve supplied muscles, unilateral
• 95868 — EMG needle, cranial nerve supplied muscles, bilateral
• 95869 — EMG needle, thoracic paraspinal muscles
• 95870 — EMG needle, limited study — single extremity, or specific muscles in 2 or more extremities
• 95885 — EMG needle, each extremity, with nerve conduction, amplitude and latency/velocity study — limited (add-on)
• 95886 — EMG needle, each extremity, with NCS — complete (add-on)
• 95887 — EMG needle, non-extremity muscles — complete, with nerve conduction (add-on)

Nerve Conduction Study Codes

• 95907 — Nerve conduction studies — 1 to 2 studies
• 95908 — Nerve conduction studies — 3 to 4 studies
• 95909 — Nerve conduction studies — 5 to 6 studies
• 95910 — Nerve conduction studies — 7 to 8 studies
• 95911 — Nerve conduction studies — 9 to 10 studies
• 95912 — Nerve conduction studies — 11 to 12 studies
• 95913 — Nerve conduction studies — 13 or more studies

Neurology E/M Coding Under 2021 AMA Guidelines

Since January 2021, E/M office visit codes are selected based on either Medical Decision Making (MDM) complexity or total time — not the traditional history and physical examination component requirements. This change significantly benefits neurology practices, where complex multi-problem MDM is routine but documentation of comprehensive H&P may be limited for follow-up visits.

Established Patient Office Visits

Most established neurology patients with conditions like epilepsy, multiple sclerosis, Parkinson's disease, or migraines qualify for at least 99214 under MDM because managing a chronic illness with exacerbations and prescription drug management meets the "moderate complexity" criteria. Practices still defaulting to 99213 for all follow-up visits are significantly underbilling.

Neuropsychological Testing CPT Codes

• 96130 — Psychological testing evaluation — first hour
• 96131 — Psychological testing evaluation — each additional hour (add-on)
• 96132 — Neuropsychological testing evaluation — first hour
• 96133 — Neuropsychological testing evaluation — each additional hour (add-on)
• 96136 — Psychological or neuropsychological test administration — first 30 minutes
• 96137 — Test administration — each additional 30 minutes (add-on)
• 96138 — Test administration by technician — first 30 minutes
• 96139 — Test administration by technician — each additional 30 minutes (add-on)

Top Neurology Billing Errors

• Billing wrong EEG code — not matching the code to the specific duration and wake/sleep state documented
• Missing prior authorization for EEG, prolonged EEG monitoring, EMG/NCS, and neuropsychological testing
• Miscounting NCS studies — billing 95908 when 95910 is supported by the documented number of studies
• Using pre-2021 E/M documentation criteria — still documenting "3 of 3 key components" instead of MDM or time
• Billing neuropsychological testing without a licensed psychologist or neuropsychologist supervising or performing the evaluation
• Missing add-on codes for prolonged EEG monitoring days beyond the initial period

How HNA Supports Neurology Practices

HNA neurology billing specialists understand EEG coding nuances, EMG/NCS study count rules, the 2021 E/M guideline requirements, and the prior authorization landscape for neurology diagnostic studies. We deliver consistent 98%+ first-pass claim rates for neurology clients and proactively manage the prior authorization workflow for every diagnostic study ordered.