# ilioinguinal-iliohypogastric injection with nerve stimulator



## celcano (Apr 21, 2015)

My physician did a ilioinguinal-iliohypogastric nerve injection.  He used a nerve stimulator or "precise placement of needle",  He billed 64425 and 95873.  Code 95873 is hitting an edit because the "primary code" is missing.  What is the appropriate code for the nerve stimulation for the needle placement?

Thank for your assistance.


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## dwaldman (Apr 21, 2015)

95873 is reported with chemodenervation procedures. It would not be reported with CPT 64425.

The electrical stimulation would be considered bundle per NCCI and could include codes that would be bundle such as:

97032 APPLICATION OF A MODALITY TO 1 OR MORE AREAS; ELECTRICAL STIMULATION (MANUAL), EACH 15 MINUTES 
97139 UNLISTED THERAPEUTIC PROCEDURE (SPECIFY) 
G0282 ELECTRICAL STIMULATION, (UNATTENDED), TO ONE OR MORE AREAS, FOR WOUND CARE OTHER THAN DESCRIBED IN G0281 
G0283 ELECTRICAL STIMULATION (UNATTENDED), TO ONE OR MORE AREAS FOR INDICATION(S) OTHER THAN WOUND CARE, AS PART OF A THERAPY PLAN OF CARE 
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Per CMS NCCI Policy manual Chapter 1 General coding principles it states

Some services are integral to large numbers of procedures.  Other services are integral to a more limited number of procedures.  Examples of services integral to a large number of procedures include: 

Surgical approach including identification of anatomical landmarks, incision, evaluation of the surgical field, debridement of traumatized tissue, lysis of adhesions, and isolation of structures limiting access to the surgical field such as bone, blood vessels, nerve, and muscles *including stimulation for identification or monitoring *

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AMA CPT Changes 2006

Two add-on codes were established in the Electromyography and Nerve Conduction Tests section for reporting needle EMG guidance with *chemodenervation and electrical stimulation guidance with chemodenervation*. Prior to the chemodenervation procedure, it is sometimes necessary to perform a more precise localization for needle placement before the chemical is injected. Therefore, the physician may perform electrical stimulation or needle EMG to achieve this localization. Code 95873 describes electrical stimulation and 95874 describes needle EMG. Either 95873 or 95874 should be reported, as appropriate, *in conjunction with chemodenervation codes 64612-64614 when electrical stimulation or needle EMG is performed for guidance prior to injection of the chemical.* Codes 95873 and 95874 should not be reported in conjunction with needle electromyography procedure codes 95860-95870. Codes 95873 and 95874 should never be reported together. Three parenthetical notes have been added following 95874 that instruct users on the proper use of these codes.


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