Neurology & Pain Management Coding Alert

Question: How should I report intraoperative monitoring?

Washington Subscriber

Answer: The appropriate code to report intraoperative monitoring is +95920 (Intraoperative neurophysiology testing, per hour [list separately in addition to code for primary procedure]). You should report this code per hour of service. The first unit describes the initial 30 to 60 minutes of service, and you may report an additional unit for each additional hour the physician provides monitoring.
 
The American Academy of Electrodiagnostic Medicine recommends that you report only "whole" units. For example, report three to 3 1/2 hours as 3 hours (95920 x 3). For between 3 1/2 hours and four hours, you should report four units of service (95920 x 4). You need not append modifier -52 (Reduced services) to 95920 if the initial service lasts less than one hour, however.
 
Code 95920 includes ongoing electrophysiologic testing and monitoring by the physician during the surgical procedure only. The physician must also perform a "baseline" study (for instance, 95860, Needle electromyography; one extremity with or without related paraspinal areas) prior to the intraoperative monitoring to provide a basis for comparison. You should report this baseline study separately, and you should not count time required to perform the baseline study toward the time credited to intra-operative monitoring. You should claim only one baseline study per claim.
 
Note: CPT includes a full list of codes that you may report as "primary procedures" with 95920.

 - Clinical and coding expertise for You Be the Coder and Reader Questions provided by Neil Busis, MD, chief of the division of neurology and director of the neurodiagnostic laboratory at the University of Pittsburgh Medical Center at Shadyside, and clinical associate professor in the department of neurology, University of Pittsburgh School of Medicine; and Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, director and senior instructor for CRN Institute, an online coding certification training center based in Absecon, N.J.