Medical PolicyMedical Policy
Policy Num: 02.007.007
Policy Name: Digital Electroencephalography
Policy ID [02.007.007] [Ar / L / M+ / P-] [0.00.00]
Last Review: June 23, 2023
Next Review: Policy Archived
Digital Electroencephalography
| Population Reference No. | Populations | Interventions | Comparators | Outcomes | |
| 1 | Individuals: · | Interventions of interest are: · Digital EEG | Comparators of interest are: · EEG alone · Other Neurologic Imaging or testin · | Relevant outcomes include: · Test acuracy · Improvement of quality of life · Fuctional Outcomes ·
| |
It is the technological method of acquiring and recording the electroencephalogram without the use of paper. Through the use of computers, the EEG waves are recorded and stored in a format digital, which, when projected on a screen, appears again in the form of waves, the preparations and details during the recording of the track are identical to those in the studio
▪ Advantages
o Allows the horizontal and vertical amplification of the recording or segment of the itself and thus increases the flexibility of reading.
o Allows, through a computer network, access to traces stored in remote locations.
o Does not use paper
▪ Disadvantages
o Some loss of detail may occur particularly in the "settings" of lowest sensitivity
This topic review discusses the use of digital electroencephalography (EEG) monitoring in the diagnosis of seizures and epilepsy as well as other diagnosis & evaluations.
Digital EEG is considered for payment:
▪ For early detection of intracranial complications during surgery neurological disorders that could result in reduced cerebral perfusion (for example: carotid endarterectomy and aneurysmal surgery).
▪ During the postoperative period; for monitoring and early detection of patients at risk of developing epileptic seizures in the care unit intensive.
▪ In the preoperative evaluation of patients with epilepsy.
▪ Extended monitoring of patients with spikes in tracings or with seizures epileptiformes, to facilitate their evaluation.
In the case that an extended digital monitoring is carried out, there is no additional payment.
Its use is not considered for payment for the following conditions:
▪ Post-concussion syndrome
▪ Mild to moderate brain trauma
▪ Learning disorders
▪ Attention disorders
▪ Schizophrenia
▪ Depression
▪ Alcoholism
▪ Abuse of controlled substances
Digital Analysis of an Electroencephalogram (EEG) is used to diagnose neurological conditions when routine EEG outcomes and neurological imaging are inconclusive to confirm diagnostic symptoms. It requires the analysis of an EEG using quantitative analytical techniques such as data selection, quantitative software processing and dipole source analysis.
It should not be used simply when the EEG was recorded digitally. There is no additional charge for turning on an automated spike and seizure detector on a routine EEG, ambulatory EEG, or videoEEG monitoring. Nor is there an additional code for performing EEG on a digital machine instead of an older generation analog machine. Some features of digital EEG make it easier and quicker to read, and other features slow it down by providing new optional tricks and tools. Overall, it is about the same amount of work as an analog EEG.
Currently, EEGs are primarily performed on digital machines instead of older analog machines. Automated spike and seizure detectors are usually built into digital routine EEG, ambulatory EEG, or video-EEG monitoring. Because of this enhancement, substantial additional analysis is typically not necessary.
Code 95957 is used when substantial additional digital analysis is medically necessary and performed, such as in 3D dipole localization. In general, this would entail an extra hour's work by the technician to process the data from the digital EEG, and an extra 20-30 minutes of physician time to review the technician's work and review the data produced. Most practitioners would not have the opportunity to do this advanced procedure. It would be more commonly used at specialty centers, e.g. epilepsy surgery programs.
Do not report code 95957 for use of automated software. For use of automated spike and seizure detection and trending software when performed with long term EEG, use appropriate codes 95706- 95726.
For approval, ALL of the following criteria must be met:
A. Documentation supports the long-term EEG is inconclusive and additional testing for possible epileptic spikes or seizures is needed; OR
B. Documentation supports topographic voltage and dipole analysis in pre-surgical candidates with intractable epilepsy; AND
C. Documentation supports substantial additional digital analysis was performed such as data selection, quantitative software processing and dipole source analysis. In general, this would entail an extra hour’s work by the technician to process the data from the digital EEG and an extra 20-30 minutes of physician time to review the technician’s work and review the data produced.
BlueCard/National Account Issues
Benefits are determined by the group contract, member benefit booklet, and/or individual subscriber certificate in effect at the time services were rendered.
Benefit products or negotiated coverages may have all or some of the services discussed in this medical policy excluded from their coverage.
Digital electroencephalography (DEEG) is the paperless acquisition and recording of the electroencephalogram (EEG) via computer-based instrumentation, with waveform storage in a digital format on electronic media, and waveform display on an electronic monitor or other computer output device. The procedure for an EEG involves placing a series of electrodes, with at least four recording channels, on the patient. A very low electrical current is sent through the electrodes and the baseline brain energy is recorded on a diagnostic machine. Electrical activity is recorded and analyzed. Patients are then exposed to a variety of external stimuli, including bright or flashing light, noise or certain drugs, or asked to open and close their eyes, or to change breathing patterns. The electrodes transmit the resulting changes in brain wave patterns. Variations in wave characteristics correlate with neurological conditions and are used to diagnose specific medical conditions. Virtually all contemporary EEG recordings use digital recording methods, which involves the use of a digital EEG recorder (machine), but still involves visual analysis of the waveforms.
Digital analysis requires the use of quantitative analytical techniques. Ideally, DEEG creates a recording on a digital medium without loss of anything except the paper itself. In practice, there may be some loss of detail especially at the lower sensitivity settings. Digital EEG also allows for simple but extremely useful digital utilities such as post hoc changes in filters, horizontal and vertical display scale and montage reformatting that allow greater flexibility in reading the EEG. These tools allow for better visual reading of the record than can be achieved with an analog paper record.
Digital EEG is significantly more comprehensive than just a digital reading of the EEG. The analysis of the digital data may include data that expands more than 24 hours of continual monitoring. In general, this would entail an extra hour’s work by the technician to process the data from the EEG, and an extra 20-30 minutes of physician time to review the technician’s work and review the data produced.
Although Digital EEG has many benefits, it should not be considered a panacea. A skilled technologist is still required to obtain a high- quality recording. Furthermore, even a good technologist can have the misfortune of recording EEG activity, such as a seizure, at a sensitivity, filter setting, or montage that hampers accurate interpretation. This problem can easily be overcome using post hoc changes to the DEEG. However, basic concepts of polarity, principles of localization and montage design, and recording parameters still need to be understood for accurate interpretation. Because there are multiple ways of viewing the data with DEEG, the time required to read the record may exceed that for analog recordings.
Borusiak, et al (2010) reported on prospective analysis of DEEG performed in 382 healthy children (226 male, 156 female) ages 6–13 years, admitted to the hospital for minor head trauma. A digital EEG recording was carried out for a minimum of 20 minutes including hyperventilation and photic stimulation. Two board‐certified clinical neurophysiologists carried out analysis.
Epileptiform EEG discharges were detected in 25 of 382 children (11 of 226 male, 14 of 156 female) corresponding to an overall prevalence of 6.5%. Of these 25 children, four had either generalized or bifrontal spikes, 12 showed constant localized focal discharges, and nine showed multifocal discharges. Compared to previous studies using non‐DEEG recording, the prevalence of epileptiform EEG discharges in our population was significantly higher. No significant difference was found when comparing our data to prevalence’s recently reported in children with behavioral disturbances using DEEG. The study further highlights the urgent need to reevaluate the prevalence of epileptiform EEG discharges in healthy children using DEEG recordings in a larger cohort.
The recording parameters and conduct of the test are governed by the applicable standards for the American Clinical Neurophysiology Society (ACNS).
Additionally, the ACNS gives specific directions for billing for digital EEG analysis:
“Code 95957 should not be used simply when the EEG was recorded digitally. There is no additional charge for turning on an automated spike and seizure detector on a routine EEG, ambulatory EEG, or video-EEG monitoring. Nor is there an additional code for performing EEG on a digital machine instead of an older generation analog machine. Some features of digital EEG make it easier and quicker to read, and other features slow it down by providing new optional tricks and tools. Overall, it is about the same amount of work as an analog EEG.
Code 95957 is used when substantial additional digital analysis was medically necessary and was performed, such as 3D dipole localization. In general, this would entail an extra hour's work by the technician to process the data from the digital EEG, and an extra 20-30 minutes of physician time to review the technician's work and review the data produced. Most practitioners would not have the opportunity to do this advanced procedure. It would be more commonly used at specialty centers, e.g. epilepsy surgery programs. Note that the codes for "monitoring for identification and lateralization of cerebral seizure focus" already include epileptic spike analysis.”
Population Reference No. 1
| Population Reference No. 1 Policy Statement | [X] MedicallyNecessary | [ ] Investigational |
N/A
1. Verma A, Radtke R. EEG of partial seizures. J Clin Neurophysiol 2006; 23:333.
2. Cascino GD. Video-EEG monitoring in adults. Epilepsia 2002; 43 Suppl 3:80.
| Codes | Number | Description |
| CPT | 95957 | Digital analysis of electroencephalogram (EEG) (eg, for epileptic spike analysis) |
| ICD-10-CM | E03.5 | Myxedema coma |
| | F11.23 | Opioid dependence with withdrawal |
| | F11.93 | Opioid use, unspecified with withdrawal |
| | F13.230 | Sedative, hypnotic or anxiolytic dependence with withdrawal, uncomplicated |
| | F13.231 | Sedative, hypnotic or anxiolytic dependence with withdrawal delirium |
| | F13.232 | Sedative, hypnotic or anxiolytic dependence with withdrawal with perceptual disturbance |
| | F13.239 | Sedative, hypnotic or anxiolytic dependence with withdrawal, unspecified |
| | F13.930 | Sedative, hypnotic or anxiolytic use, unspecified with withdrawal, uncomplicated |
| | F13.931 | Sedative, hypnotic or anxiolytic use, unspecified with withdrawal delirium |
| | F13.932 | Sedative, hypnotic or anxiolytic use, unspecified with withdrawal with perceptual disturbances |
| | F13.939 | Sedative, hypnotic or anxiolytic use, unspecified with withdrawal, unspecified |
| | F14.23 | Cocaine dependence with withdrawal |
| | F15.23 | Other stimulant dependence with withdrawal |
| | F15.93 | Other stimulant use, unspecified with withdrawal |
| | F17.203 | Nicotine dependence unspecified, with withdrawal |
| | F17.213 | Nicotine dependence, cigarettes, with withdrawal |
| | F17.223 | Nicotine dependence, chewing tobacco, with withdrawal |
| | F17.293 | Nicotine dependence, other tobacco product, with withdrawal |
| | F19.230 | Other psychoactive substance dependence with withdrawal, uncomplicated |
| | F19.231 | Other psychoactive substance dependence with withdrawal delirium |
| | F19.232 | Other psychoactive substance dependence with withdrawal with perceptual disturbance |
| F19.239 | Other psychoactive substance dependence with withdrawal, unspecified | |
| | F19.930 | Other psychoactive substance use, unspecified with withdrawal, uncomplicated |
| | F19.931 | Other psychoactive substance use, unspecified with withdrawal delirium |
| | F19.932 | Other psychoactive substance use, unspecified with withdrawal with perceptual disturbance |
| | F19.939 | Other psychoactive substance use, unspecified with withdrawal, unspecified |
| | G35 | Multiple sclerosis |
| | G40.001 | Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, with status epilepticus |
| | G40.009 | Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, without status epilepticus |
| | G40.011 | Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, with status epilepticus |
| | G40.019 | Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, without status epilepticus |
| | G40.101 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus |
| | G40.109 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus |
| | G40.111 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus |
| | G40.119 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus |
| | G40.201 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, with status epilepticus |
| | G40.209 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic |
| | G40.211 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus |
| | G40.219 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, without status epilepticus |
| | G40.301 | Generalized idiopathic epilepsy and epileptic syndromes, not intractable, with status epilepticus |
| | G40.309 | Generalized idiopathic epilepsy and epileptic syndromes, not intractable, without status epilepticus |
| | G40.311 | Generalized idiopathic epilepsy and epileptic syndromes, intractable, with status epilepticus |
| | G40.319 | Generalized idiopathic epilepsy and epileptic syndromes, intractable, without status epilepticus |
| | G40.401 | Other generalized epilepsy and epileptic syndromes, not intractable, with status epilepticus |
| | G40.409 | Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus |
| | G40.411 | Other generalized epilepsy and epileptic syndromes, intractable, with status epilepticus |
| | G40.419 | Other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus |
| | G40.501 | Epileptic seizures related to external causes, not intractable, with status epilepticus |
| | G40.509 | Epileptic seizures related to external causes, not intractable, without status epilepticus |
| | G40.801 | Other epilepsy, not intractable, with status epilepticus |
| | G40.802 | Other epilepsy, not intractable, without status epilepticus |
| | G40.803 | Other epilepsy, intractable, with status epilepticus |
| | G40.804 | Other epilepsy, intractable, without status epilepticus |
| | G40.811 | Lennox-Gastaut syndrome, not intractable, with status epilepticus |
| | G40.812 | Lennox-Gastaut syndrome, not intractable, without status epilepticus |
| | G40.813 | Lennox-Gastaut syndrome, intractable, with status epilepticus |
| | G40.814 | Lennox-Gastaut syndrome, intractable, without status epilepticus |
| | G40.821 | Epileptic spasms, not intractable, with status epilepticus |
| | G40.822 | Epileptic spasms, not intractable, without status epilepticus |
| | G40.823 | Epileptic spasms, intractable, with status epilepticus |
| | G40.824 | Epileptic spasms, intractable, without status epilepticus |
| | G40.89 | Other seizures |
| | G40.901 | Epilepsy, unspecified, not intractable, with status epilepticus |
| | G40.909 | Epilepsy, unspecified, not intractable, without status epilepticus |
| | G40.911 | Epilepsy, unspecified, intractable, with status epilepticus |
| | G40.919 | Epilepsy, unspecified, intractable, without status epilepticus |
| | G40.A01 | Absence epileptic syndrome, not intractable, with status epilepticus |
| | G40.A09 | Absence epileptic syndrome, not intractable, without status epilepticus |
| | G40.A11 | Absence epileptic syndrome, intractable, with status epilepticus |
| | G40.A19 | Absence epileptic syndrome, intractable, without status epilepticus |
| | G40.B01 | Juvenile myoclonic epilepsy, not intractable, with status epilepticus |
| | G40.B09 | Juvenile myoclonic epilepsy, not intractable, without status epilepticus |
| | G40.B11 | Juvenile myoclonic epilepsy, intractable, with status epilepticus |
| | G40.B19 | Juvenile myoclonic epilepsy, intractable, without status epilepticus |
| | G43.009 | Migraine without aura, not intractable, without status migrainosus |
| | G43.101 | Migraine with aura, not intractable, with status migrainosus |
| | G43.109 | Migraine with aura, not intractable, without status migrainosus |
| | G43.111 | Migraine with aura, intractable, with status migrainosus |
| | G43.119 | Migraine with aura, intractable, without status migrainosus |
| | G43.401 | Hemiplegic migraine, not intractable, with status migrainosus |
| | G43.409 | Hemiplegic migraine, not intractable, without status migrainosus |
| | G43.411 | Hemiplegic migraine, intractable, with status migrainosus |
| | G43.419 | Hemiplegic migraine, intractable, without status migrainosus |
| | G43.501 | Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus |
| | G43.509 | Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus |
| | G43.511 | Persistent migraine aura without cerebral infarction, intractable, with status migrainosus |
| | G43.519 | Persistent migraine aura without cerebral infarction, intractable, without status migrainosus |
| | G43.601 | Persistent migraine aura with cerebral infarction, not intractable, with status migrainosus |
| | G43.609 | Persistent migraine aura with cerebral infarction, not intractable, without status migrainosus |
| | G43.611 | Persistent migraine aura with cerebral infarction, intractable, with status migrainosus |
| | G43.619 | Persistent migraine aura with cerebral infarction, intractable, without status migrainosus |
| | G43.709 | Chronic migraine without aura, not intractable, without status migrainosus |
| | G43.809 | Other migraine, not intractable, without status migrainosus |
| | G43.829 | Menstrual migraine, not intractable, without status migrainosus |
| | G43.909 | Migraine, unspecified, not intractable, without status migrainosus |
| | G43.A0 | Cyclical vomiting, not intractable |
| | G43.B0 | Ophthalmoplegic migraine, not intractable |
| | G43.C0 | Periodic headache syndromes in child or adult, not intractable |
| | G43.D0 | Abdominal migraine, not intractable |
| | G47.09 | Other insomnia |
| | G47.411 | Narcolepsy with cataplexy |
| | G47.419 | Narcolepsy without cataplexy |
| | G47.421 | Narcolepsy in conditions classified elsewhere with cataplexy |
| | G47.429 | Narcolepsy in conditions classified elsewhere without cataplexy |
| | R40.0 | Somnolence |
| | R40.1 | Stupor |
| | R40.20 | Unspecified coma |
| | R40.2110 | Coma scale, eyes open, never, unspecified time |
| | R40.2111 | Coma scale, eyes open, never, in the field [EMT or ambulance] |
| | R40.2112 | Coma scale, eyes open, never, at arrival to emergency department |
| | R40.2113 | Coma scale, eyes open, never, at hospital admission |
| | R40.2114 | Coma scale, eyes open, never, 24 hours or more after hospital admission |
| | R40.2120 | Coma scale, eyes open, to pain, unspecified time |
| | R40.2121 | Coma scale, eyes open, to pain, in the field [EMT or ambulance] |
| | R40.2122 | Coma scale, eyes open, to pain, at arrival to emergency department |
| | R40.2123 | Coma scale, eyes open, to pain, at hospital admission |
| | R40.2124 | Coma scale, eyes open, to pain, 24 hours or more after hospital admission |
| | R40.2130 | Coma scale, eyes open, to sound, unspecified time |
| | R40.2131 | Coma scale, eyes open, to sound, in the field [EMT or ambulance] |
| | R40.2132 | Coma scale, eyes open, to sound, at arrival to emergency department |
| | R40.2133 | Coma scale, eyes open, to sound, at hospital admission |
| | R40.2134 | Coma scale, eyes open, to sound, 24 hours or more after hospital admission |
| | R40.2140 | Coma scale, eyes open, spontaneous, unspecified time |
| | R40.2141 | Coma scale, eyes open, spontaneous, in the field [EMT or ambulance] |
| | R40.2142 | Coma scale, eyes open, spontaneous, at arrival to emergency department |
| | R40.2144 | Coma scale, eyes open, spontaneous, 24 hours or more after hospital admission |
| | R40.2210 | Coma scale, best verbal response, none, unspecified time |
| | R40.2211 | Coma scale, best verbal response, none, in the field [EMT or ambulance] |
| | R40.2212 | Coma scale, best verbal response, none, at arrival to emergency department |
| | R40.2213 | Coma scale, best verbal response, none, at hospital admission |
| | R40.2214 | Coma scale, best verbal response, none, 24 hours or more after hospital admission |
| | R40.2220 | Coma scale, best verbal response, incomprehensible words, unspecified time |
| | R40.2221 | Coma scale, best verbal response, incomprehensible words, in the field [EMT or ambulance] |
| | R40.2222 | Coma scale, best verbal response, incomprehensible words, at arrival to emergency department |
| | R40.2223 | Coma scale, best verbal response, incomprehensible words, at hospital admission |
| | R40.2224 | Coma scale, best verbal response, incomprehensible words, 24 hours or more after hospital admission |
| | R40.2230 | Coma scale, best verbal response, inappropriate words, unspecified time |
| | R40.2231 | Coma scale, best verbal response, inappropriate words, in the field [EMT or ambulance] |
| | R40.2232 | Coma scale, best verbal response, inappropriate words, at arrival to emergency department |
| | R40.2233 | Coma scale, best verbal response, inappropriate words, at hospital admission |
| | R40.2234 | Coma scale, best verbal response, inappropriate words, 24 hours or more after hospital admission |
| | R40.2240 | Coma scale, best verbal response, confused conversation, unspecified time |
| | R40.2241 | Coma scale, best verbal response, confused conversation, in the field [EMT or ambulance] |
| | R40.2242 | Coma scale, best verbal response, confused conversation, at arrival to emergency department |
| | R40.2243 | Coma scale, best verbal response, confused conversation, at hospital admission |
| | R40.2244 | Coma scale, best verbal response, confused conversation, 24 hours or more after hospital admission |
| | R40.2250 | Coma scale, best verbal response, oriented, unspecified time |
| | R40.2251 | Coma scale, best verbal response, oriented, in the field [EMT or ambulance] |
| | R40.2252 | Coma scale, best verbal response, oriented, at arrival to emergency department |
| | R40.2253 | Coma scale, best verbal response, oriented, at hospital admission |
| | R40.2254 | Coma scale, best verbal response, oriented, 24 hours or more after hospital admission |
| | R40.2310 | Coma scale, best motor response, none, unspecified time |
| | R40.2311 | Coma scale, best motor response, none, in the field [EMT or ambulance] |
| | R40.2312 | Coma scale, best motor response, none, at arrival to emergency department |
| | R40.2313 | Coma scale, best motor response, none, at hospital admission |
| | R40.2314 | Coma scale, best motor response, none, 24 hours or more after hospital admission |
| | R40.2320 | Coma scale, best motor response, extension, unspecified time |
| | R40.2321 | Coma scale, best motor response, extension, in the field [EMT or ambulance] |
| | R40.2322 | Coma scale, best motor response, extension, at arrival to emergency department |
| | R40.2323 | Coma scale, best motor response, extension, at hospital admission |
| | R40.2324 | Coma scale, best motor response, extension, 24 hours or more after hospital admission |
| | R40.2330 | Coma scale, best motor response, abnormal, unspecified time |
| | R40.2331 | Coma scale, best motor response, abnormal, in the field [EMT or ambulance] |
| | R40.2332 | Coma scale, best motor response, abnormal, at arrival to emergency department |
| | R40.2333 | Coma scale, best motor response, abnormal, at hospital admission |
| | R40.2334 | Coma scale, best motor response, abnormal, 24 hours or more after hospital admission |
| | R40.2340 | Coma scale, best motor response, flexion withdrawal, unspecified time |
| | 40.2341 | Coma scale, best motor response, flexion withdrawal, in the field [EMT or ambulance] |
| | R40.2342 | Coma scale, best motor response, flexion withdrawal, at arrival to emergency department |
| | R40.2343 | Coma scale, best motor response, flexion withdrawal, at hospital admission |
| | R40.2344 | Coma scale, best motor response, flexion withdrawal, 24 hours or more after hospital admission |
| | R40.2350 | Coma scale, best motor response, localizes pain, unspecified time |
| | R40.2351 | Coma scale, best motor response, localizes pain, in the field [EMT or ambulance] |
| | R40.2352 | Coma scale, best motor response, localizes pain, at arrival to emergency department |
| | R40.2353 | Coma scale, best motor response, localizes pain, at hospital admission |
| | R40.2354 | Coma scale, best motor response, localizes pain, 24 hours or more after hospital admission |
| | R40.2360 | Coma scale, best motor response, obeys commands, unspecified time |
| | R40.2361 | Coma scale, best motor response, obeys commands, in the field [EMT or ambulance] |
| | R40.2362 | Coma scale, best motor response, obeys commands, at arrival to emergency department |
| | R40.3 | Persistent vegetative state |
| | R40.4 | Transient alteration of awareness |
| | R42 | Dizziness and giddiness |
| | R56.00 | Simple febrile convulsions |
| | R56.01 | Complex febrile convulsions |
| | R56.1 | Post traumatic seizures |
| | R56.9 | Unspecified convulsions |
| | S01.90xA | Unspecified open wound of unspecified part of head, initial encounter |
| | S01.90XD | Unspecified open wound of unspecified part of head, subsequent encounter |
| | S01.90XS | Unspecified open wound of unspecified part of head, sequela |
| | S06.363A | Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 1 hours to 5 hours 59 minutes, initial encounter |
| | S06.363D | Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 1 hours to 5 hours 59 minutes, subsequent encounter |
| | S06.363S | Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 1 hours to 5 hours 59 minutes, sequela |
| | S06.5X0A | Traumatic subdural hemorrhage without loss of consciousness, initial encounter |
| | S06.5X0D | Traumatic subdural hemorrhage without loss of consciousness, subsequent encounter |
| | S06.5X0S | Traumatic subdural hemorrhage without loss of consciousness, sequela |
| | S06.5X1A | Traumatic subdural hemorrhage with loss of consciousness of 30 minutes or less, initial encounter |
| | S06.5X1D | Traumatic subdural hemorrhage with loss of consciousness of 30 minutes or less, subsequent encounter |
| | S06.5X1S | Traumatic subdural hemorrhage with loss of consciousness of 30 minutes or less, sequela |
| | S06.5X2A | Traumatic subdural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, initial encounter |
| | S06.5X2D | Traumatic subdural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, subsequent encounter |
| | S06.5X2S | Traumatic subdural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, sequela |
| | S06.5X3A | Traumatic subdural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter |
| | S06.5X3D | Traumatic subdural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, subsequent encounter |
| | S06.5X3S | Traumatic subdural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela |
| | S06.5X4A | Traumatic subdural hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter |
| | S06.5X4D | Traumatic subdural hemorrhage with loss of consciousness of 6 hours to 24 hours, subsequent encounter |
| | S06.5X4S | Traumatic subdural hemorrhage with loss of consciousness of 6 hours to 24 hours, sequela |
| | S06.5X5A | Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter |
| | S06.5X5D | Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, subsequent encounter |
| | S06.5X5S | Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela |
| | S06.5X6A | Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter |
| | S06.5X6D | Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, subsequent encounter |
| | S06.5X6S | Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela |
| | S06.5X7A | Traumatic subdural hemorrhage with loss of consciousness of any duration with death due to brain injury before regaining consciousness, initial encounter |
| | S06.5X7D | Traumatic subdural hemorrhage with loss of consciousness of any duration with death due to brain injury before regaining consciousness, subsequent encounter |
| | S06.5X7S | Traumatic subdural hemorrhage with loss of consciousness of any duration with death due to brain injury before regaining consciousness, sequela |
| | S06.5X8A | Traumatic subdural hemorrhage with loss of consciousness of any duration with death due to other cause before regaining consciousness, initial encounter |
| | S06.5X8D | Traumatic subdural hemorrhage with loss of consciousness of any duration with death due to other cause before regaining consciousness, subsequent encounter |
| | S06.5X8S | Traumatic subdural hemorrhage with loss of consciousness of any duration with death due to other cause before regaining consciousness, sequela |
| | S06.5X9A | Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, initial encounter |
| | S06.5X9D | Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, subsequent encounter |
| | S06.5X9S | Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, sequela |
| | S06.6X3A | Traumatic subarachnoid hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter |
| | S06.6X3D | Traumatic subarachnoid hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, subsequent encounter |
| | S06.6X3S | Traumatic subarachnoid hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela |
| | S06.6X4A | Traumatic subarachnoid hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter |
| | S06.6X4D | Traumatic subarachnoid hemorrhage with loss of consciousness of 6 hours to 24 hours, subsequent encounter |
| | S06.6X4S | Traumatic subarachnoid hemorrhage with loss of consciousness of 6 hours to 24 hours, sequela |
| | S06.6X5A | Traumatic subarachnoid hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter |
| | S06.6X5D | Traumatic subarachnoid hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, subsequent encounter |
| | S06.6X5S | Traumatic subarachnoid hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela |
| | S06.6X6A | Traumatic subarachnoid hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter |
| | S06.6X6D | Traumatic subarachnoid hemorrhage with loss of consciousness greater than |
| | S06.6X6S | Traumatic subarachnoid hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela |
| | S06.6X9A | Traumatic subarachnoid hemorrhage with loss of consciousness of unspecified duration, initial encounter |
| | S06.6X9D | Traumatic subarachnoid hemorrhage with loss of consciousness of unspecified duration, subsequent encounter |
| | S06.6X9S | Traumatic subarachnoid hemorrhage with loss of consciousness of unspecified duration, sequela |
| Date | Action | Description |
| 06/23/2023 | Replace policy | New Format |
| 08/22/2017 | | |
| 05/10/2016 | | |
| 09/30/2013 | Replace policy | Added ICD-10 CM |
| 09/09/2013 | Replace policy | Added ICD-10 CM |
| 09/30/2011 | Replace policy | Added ICD-10 CM |
| 04/12/2009 | iCES | |
| 05/09/2007 | | |
| 02/11/2005 | | |
| 09/30/1999 | Created | New policy |