Neurology & Pain Management Coding Alert

Question: Is a nurse practitioner allowed to render service to a patient for CPT®'s electronic analysis for a neurostimulator pulse generator? Does it have to be done by the physician only? Your input is greatly appreciated.

Colorado Subscriber

Answer: The "Instructions for Use" section of the CPT® Codebook, found in the front Introduction section of the codebook, states "Any procedure or service in any section of this book may be used to designate the services rendered by any qualified physician or other qualified health care professional or entity...A "physician or other qualified healthcare professional" is an individual who is qualified by education, training, licensure/regulation (when applicable), and facility privileges (when applicable) who performs a professional service within his/her scope of practice and independently reports that professional service."

As a result, you will need to check with your specific state's scope of practice for nurse practitioners to determine what, if any, limitations for services / procedures that they can perform.

When you code for analysis of pulse generator systems, choose between two primary codes:

• 95970 -- Electronic analysis of implanted neurostimulator pulse generator system (e.g., rate, pulse amplitude pulse duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient compliance measurements); simple or complex brain, spinal cord, or peripheral (i.e. cranial nerve, peripheral nerve, sacral nerve, neuromuscular) neurostimulator pulse generator/transmitter, without reprogramming
• 95978 -- Electronic analysis of implanted neurostimulator pulse generator system (e.g., rate, pulse amplitude and duration, battery status, electrode selectability and polarity, impedance and patient compliance measurements), complex deep brain neurostimulator pulse generator/transmitter, with initial or subsequent programming; first hour