Revenue Cycle Insider

Question: Could you explain what autonomic nervous system function testing via vasomotor adrenergic innervation is, and how I should report it?

Ohio Subscriber

Answer: At times, providers perform autonomic nervous system testing to check the sympathetic function of the autonomic nervous system; this gives them clues to the nature and severity of potential autonomic disorders. Autonomic disorders affect the autonomic nervous system; this is the part of the nervous system that controls several bodily functions, including blood pressure (BP), pulse rate, and sweating.

The code you’ll use for this test performed via vasomotor adrenergic innervation is 95922 (Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and R-R interval changes during Valsalva maneuver and at least 5 minutes of passive tilt). Be careful, however, as CPT^® requires the provider to perform several services in order to report 95922 legitimately.

When reporting 95922, CPT^® requires the provider to perform and document all of the following:

1. “Continuous recording of beat-to-beat BP and heart rate. The heart rate needs to be derived from an electrocardiogram (ECG) unit such that an accurate quantitative graphical measurement of the R-R interval is obtained.
2. “A period of supine rest of at least 20 minutes prior to testing.
3. “The performance and recording of beat-to-beat blood pressure and heart rate during a minimum of two (2) Valsalva maneuvers.
4. “The performance of passive head-up tilt with continuous recording of beat-to-beat blood pressure and heart rate for a minimum of five minutes, followed by passive tilt-back to the supine position. This must be performed using a tilt table.”

Best bet: Make sure you spot all of these components before choosing 95922. If you have any doubt about the documentation, query the provider before coding the claim.

Chris Boucher, MS, CPC, Senior Development Editor, AAPC