ARCHIVED


2.07.03ARCHIVADA ELECTROENCEFALOGRAFIA CON EKG
SecciónMedicina Fecha Original: 19 de agosto de 1998
SubsecciónNeurología Fecha Revisión10 de mayo de 2016
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Definición


El electroencefalograma es una grabación permanente de los potenciales eléctricos generados por las neuronas cerebrales. Variaciones en las características de estas ondas eléctricas se correlacionan con condiciones neurológicas y son usadas en el diagnóstico de las mismas.
El EEG es indispensable en la evaluación de la patología en la materia gris cerebral y constituye el único procedimiento electrofisiológico capaz de medir el funcionamiento córtico cerebral.
Política
Triple-S considerará para pago el estudio electroencefalográfico en aquellas situaciones y condiciones en las que se documenta la necesidad médica.
  • Indicaciones principales:

  • Evaluación del paciente en quien se sospecha desórdenes convulsivos.

  • Evaluación del paciente comatoso y otras anormalidades del estado mental. El EEG es anormal en la mayoría de los casos de encefalopatía metabólica o isquémica y es normal en la mayoría de las condiciones siquiátricas.

  • Evaluación de procesos infecciosos del sistema nervioso central. Patrones característicos del EEG son vistos en pacientes con encefalitis por Herpes simplex, en la enfermedad de Creutzfeldt-jakob y en la panencefalitis esclerosante subaguda.

  • Indicaciones adicionales incluyen:

  • Evaluación del paciente con trauma cráneo cerebral. El EEG luego de una concusión cerebral es usualmente normal, mientras que luego de una contusión cerebral es usualmente anormal.

  • Evaluación de desórdenes de sueño.

  • Evaluación y monitoreo intraoperatorio de actividad cerebral durante procedimientos quirúrgicos tales como endarderectomía de carótidas o en cirugía cardiotoráxica.

  • En la evaluación de pseudoconvulsiones el EEG es normal a pesar de la presencia de actividad muscular clónica generalizada.

    • Electrocardiogramas asociados con electroencefalogramas
    Triple-S, no considerará para pago el electrocardiograma (93000, 93005, 93010) generado previo al EEG.
    De igual manera no se considerará para pago los “rhythm strips” (códigos ECG 93040, 93042), ya que los mismos se consideran como parte integral del procedimiento electroencefalográfico, no por separado.
    Códigos
    Códigos CPT y ICD-9 DM que satisfacen el requerimiento de necesidad médica:
    V1 V2
    CPT DESCRIPCION
    95812 Electroencephalogram (EEG) extended monitoring; 41-60 minutes
    95813 Electroencephalogram (EEG) extended monitoring; greater than one hour
    95816 Electroencephalogram (EEG); including recording awake and drowsy
    95819 Electroencephalogram (EEG); including recording awake and asleep
    95822 Electroencephalogram (EEG); including recording in coma or sleep only
    95824 Electroencephalogram (EEG); cerebral death evaluation only
    95827 Electroencephalogram (EEG); all night recording
    ICD-9 Diagnosis DESCRIPCION
    046.19 Other and unspecified Creutzfeldt-Jakob disease
    046.2 Subacute sclerosing panencephalitis
    049.9 Unspecified non-arthropod-borne viral diseases of central nervous system
    345.0 - 345.91 Epilepsy and recurrent seizures
    346.00 Migraine with aura
    347.00-347.11 Cataplexy and narcolepsy
    348.31 Metabolic encephalopathy
    768.70 Hypoxic-ischemic encephalopathy, unspecified
    780.01 Coma
    780.31-780.39 Convulsions
    851.00-851.99 Cerebral laceration and contusion (code range)
    852.00-852.59 Subarachnoid subdural and extradural hemorrhage following injury(code range)
    853.00 - 853.19 Other and unspecified intracranial hemorrhage following injury(code range)
    854.00-854.19 Intracranial injury of other and unspecified nature(code range)

    ICD-10-CM(effective 10/1/2015) Descripción
    G40.309 idiopathic epilepsy, not intractable, w/o stat epi Generalized idiopathic epilepsy and epileptic syndromes, not intractable, without status epilepticus
    G40.311 idiopathic epilepsy, intractable, w stat epi Generalized idiopathic epilepsy and epileptic syndromes, intractable, with status epilepticus
    G40.309 idiopathic epilepsy, not intractable, w/o stat epi Generalized idiopathic epilepsy and epileptic syndromes, not intractable, without status epilepticus
    G40.311 idiopathic epilepsy, intractable, w stat epi Generalized idiopathic epilepsy and epileptic syndromes, intractable, with status epilepticus
    G40.301 idiopathic epilepsy, not intractable, w stat epi Generalized idiopathic epilepsy and epileptic syndromes, not intractable, with status epilepticus
    G40.301 idiopathic epilepsy, not intractable, w stat epi Generalized idiopathic epilepsy and epileptic syndromes, not intractable, with status epilepticus
    G40.201 symptc epi w cmplx prt seiz, not ntrct, w stat epi Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, with status epilepticus
    G40.209 symptc epi w cmplx prt seiz,not ntrct,w/o stat epi Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus
    G40.211 symptc epi w cmplx partial seiz, ntrct, w stat epi Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus
    G40.219 symptc epi w cmplx part seiz, ntrct, w/o stat epi Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, without status epilepticus
    G40.101 symptc epi w simp part seiz, not ntrct, w stat epi Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus
    G40.109 symptc epi w simp prt seiz,not ntrct, w/o stat epi Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus
    G40.111 symptc epi w simple part seiz, ntrct, w stat epi Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus
    G40.119 symptc epi w simple part seiz, ntrct, w/o stat epi Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus
    G40.401 generalized epilepsy, not intractable, w stat epi Other generalized epilepsy and epileptic syndromes, not intractable, with status epilepticus
    G40.409 generalized epilepsy, not intractable, w/o stat epi Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus
    G40.411 generalized epilepsy, intractable, w status epilepticus Other generalized epilepsy and epileptic syndromes, intractable, with status epilepticus
    G40.419 generalized epilepsy, intractable, w/o stat epi Other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus
    G40.101 symptc epi w simp part seiz, not ntrct, w stat epi Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus
    G40.109 symptc epi w simp prt seiz,not ntrct, w/o stat epi Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus
    G40.111 symptc epi w simple part seiz, ntrct, w stat epi Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus
    G40.119 symptc epi w simple part seiz, ntrct, w/o stat epi Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus
    G40.101 symptc epi w simp part seiz, not ntrct, w stat epi Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus
    G40.109 symptc epi w simp prt seiz,not ntrct, w/o stat epi Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus
    G40.501 seiz rel to extrn causes, not ntrct, w stat epi Epileptic seizures related to external causes, not intractable, with status epilepticus
    G40.509 seiz rel to extrn causes, not ntrct, w/o stat epi Epileptic seizures related to external causes, not intractable, without status epilepticus
    G40.802 epilepsy, not intractable, without status epilepticus Other epilepsy, not intractable, without status epilepticus
    G40.111 symptc epi w simple part seiz, ntrct, w stat epi Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus
    G40.119 symptc epi w simple part seiz, ntrct, w/o stat epi Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus
    G40.804 epilepsy, intractable, without status epilepticus Other epilepsy, intractable, without status epilepticus
    G40.901 unsp, not intractable, with status epilepticus Epilepsy, unspecified, not intractable, with status epilepticus
    G40.909 unsp, not intractable, without status epilepticus Epilepsy, unspecified, not intractable, without status epilepticus
    G40.911 unspecified, intractable, with status epilepticus Epilepsy, unspecified, intractable, with status epilepticus
    G40.919 unsp, intractable, without status epilepticus Epilepsy, unspecified, intractable, without status epilepticus
    G43.109 with aura, not intractable, w/o status migrainosus Migraine with aura, not intractable, without status migrainosus
    G47.419 without cataplexy Narcolepsy without cataplexy
    R56.00 febrile convulsions Simple febrile convulsions
    R56.01 febrile convulsions Complex febrile convulsions
    R56.1 traumatic seizures Post traumatic seizures
    R56.9 convulsions Unspecified convulsions
    S06.5X0A subdr hem w/o loss of consciousness, init Traumatic subdural hemorrhage without loss of consciousness, initial encounter
    S06.5X0A subdr hem w/o loss of consciousness, init Traumatic subdural hemorrhage without loss of consciousness, initial encounter
    S06.5X1A subdr hem w LOC of 30 minutes or less, init Traumatic subdural hemorrhage with loss of consciousness of 30 minutes or less, initial encounter
    S06.5X2A subdr hem w loss of consciousness of 31-59 min, init Traumatic subdural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, initial encounter
    S06.5X5A subdr hem w LOC >24 hr w ret consc lev, init Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter
    S06.5X9A subdr hem w LOC of unsp duration, init Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, initial encounter
    S06.5X0A subdr hem w/o loss of consciousness, init Traumatic subdural hemorrhage without loss of consciousness, initial encounter
    S06.5X9A subdr hem w LOC of unsp duration, init Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, initial encounter
    S01.90XA open wound of unspecified part of head, init encntr Unspecified open wound of unspecified part of head, initial encounter
    S06.5X0A subdr hem w/o loss of consciousness, init Traumatic subdural hemorrhage without loss of consciousness, initial encounter

    Limitación
    Según las establecidas en la póliza.
    ___________ ____________________________________
    Ángela Hernández, MD Enid M. Mateo Reyes, MD
    Director Médico Asociado Director Médico Asociado
    Rev. 5/10/2016
    5/15/2013
    09/26/10
    04/08/09 (iCES)
    05/30/07
    02/11/05
    08/19/98

    Referencias

  • Buzsaki, G, Traub, et al. The Cellular Basis of EEG Activity. In: Current Practice of Clinical Electroencephalography, Ebersole, JS, Pedley, TA (Eds), Lippincott Williams & Wilkins, Philadelphia 2003. p.1.

  • Goodin DS, Aminoff MJ. Does the interictal EEG have a role in the diagnosis of epilepsy? Lancet 1984; 1:837

  • Pillai J, Sperling MR. Interictal EEG and the diagnosis of epilepsy. Epilepsia 2006; 47 Suppl 1:14.

  • Liporace J, Tatum W 4th, Morris GL 3rd, French J. Clinical utility of sleep-deprived versus computer-assisted ambulatory 16-channel EEG in epilepsy patients: a multi-center study. Epilepsy Res 1998; 32:357.