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Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of EEG re

CPT4 code

Name of the Procedure:

Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of EEG recording.

Summary

An Electroencephalogram (EEG) is a test that measures and records the electrical activity of the brain over a period greater than 84 hours. It is commonly used to monitor and analyze brain activity for prolonged periods to detect abnormalities such as spikes or seizures. The recorded data is reviewed and interpreted by a qualified healthcare professional, and a comprehensive report is generated.

Purpose

This procedure is primarily used to diagnose and monitor neurological conditions such as epilepsy and other seizure disorders. The goal is to detect abnormal electrical activity in the brain, which can aid in diagnosing the condition and guiding treatment decisions.

Indications

  • Chronic or recurrent seizures
  • Suspected epilepsy
  • Unexplained episodes of loss of consciousness
  • Monitoring the effectiveness of seizure medications
  • Pre-surgical evaluation for epilepsy surgery
  • Any condition requiring extended monitoring of brain activity

Preparation

  • Patients may be advised to wash their hair to ensure that the electrodes adhere well.
  • Certain medications might need to be adjusted under physician guidance.
  • Avoiding caffeine and other stimulants might be recommended.
  • No fasting is typically required.

Procedure Description

  1. The patient's scalp is cleaned, and electrodes are attached using an adhesive gel.
  2. The patient will wear a portable EEG recording device for a period exceeding 84 hours.
  3. During the monitoring, the patient continues daily activities, while the device records brain activity.
  4. The recorded data is periodically checked and reviewed by healthcare professionals.
  5. At the end of the monitoring period, the electrodes are removed.
  6. A physician or qualified healthcare professional analyzes the data for seizures or spikes.
  7. An interpretation and summary report is generated.

Duration

The continuous recording lasts greater than 84 hours, typically 3 to 5 days.

Setting

The procedure can be performed in a hospital, outpatient clinic, or at home with portable equipment.

Personnel

  • Neurologist or qualified healthcare professional for interpretation and analysis
  • EEG technician for electrode placement and initial setup

Risks and Complications

  • Skin irritation from electrodes
  • Discomfort from wearing the device for extended periods
  • Potential allergic reaction to adhesive gels

Benefits

  • Accurate diagnosis of seizure disorders
  • Better understanding of seizure frequency and triggers
  • Assist in treatment planning and assessing treatment effectiveness

Recovery

  • No significant recovery time is required.
  • There might be minor skin irritation where electrodes were placed.
  • Patients can resume normal activities immediately after the procedure.

Alternatives

  • Routine EEG (usually 20-40 minutes in duration)
  • Video EEG monitoring
  • MRI or CT scans for structural brain analysis
Pros and Cons of Alternatives
  • Routine EEG: Shorter, less cumbersome but may not capture infrequent events.
  • Video EEG: Provides visual correlation with EEG but generally requires hospitalization.
  • MRI/CT: Good for structural anomalies but do not record electrical activity.

Patient Experience

Patients might feel some initial minor discomfort during electrode placement. The device could be somewhat cumbersome during daily activities. Pain is generally minimal, and comfort measures include adjusting the way the device is worn to reduce irritation or interference with normal activities.

Medical Policies and Guidelines for Electroencephalogram (EEG), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of EEG re

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