CMS Pub. 100-03, ch. 1, § 160.21

CIM - 50-39

Telephone transmission of electroencephalograms (EEGs) is covered as a physician’s

service, or as incident to a physician’s service when reasonable and necessary for the

individual patient, under appropriate circumstances. The service is safe, and may save

time and cost in sending EEGs from remote areas without special competence in

neurology, neurosurgery, and electroencephalography, by avoiding the need to transport

patients to large medical centers for standard EEG testing.

Telephone transmission of EEGs has been most helpful in the following clinical

situations:

• Altered consciousness, such as stuporous, semicomatose, or comatose states;

• A typical seizure variants in patients experiencing bizarre, distressing symptoms

as seen with “spike and wave stupor” or other forms of seizure disorders;

• Diagnosis of a suspected intracranial tumor;

• Head injury, where a subdural hematoma may be identified;

• Headaches during the acute phase where, for instance, in migraine syndrome,

abnormal responses may be seen.

Telephonically transmitted EEGs should not be used for determining electrical inactivity

(i.e., brain death), because of unavoidable signal interference.