Neurology & Pain Management Coding Alert

Question: What is the difference in the terminology for 95885 "with related paraspinal areas" and 95887 for "axial muscles"? If the clinician does the EMG on the lumbar mid paraspinal muscle and the lumbar low paraspinal muscle, should we consider these as axial muscles?

New York Subscriber

Answer: You will need to understand the descriptors a little better. Code 95885 (Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited [List separately in addition to code for primary procedure]) is for needle electromyography in the extremity. The descriptor says "with related paraspinal areas, when performed." This is a clear situation where you report the paraspinal areas if performed in association with EMG testing of extremity muscles. The related paraspinal areas are included in this descriptor because the nerves that supply the extremities derive from the spinal cord and the testing of the paraspinal areas may be important to understand which part of the nerve has an alteration in conduction.

In code 95887 (Needle electromyography, non-extremity [cranial nerve supplied or axial] muscle[s] done with nerve conduction, amplitude and latency/velocity study [List separately in addition to code for primary procedure]), the descriptor clearly describes EMG testing of the "non-extremity (cranial nerve supplied or axial) muscle(s)." Hence when the axial muscles are tested on the same day as nerve conduction studies but not in association with extremity muscle EMG testing, the 95887 code would be reported.

The February 2012 CPT® Assistant included the following directions, "Code 95887 is intended to be used per site tested. Sites recognized are unilateral face, cervical, thoracic paraspinal muscles, larynx, hemidiaphragm, thoracic, and abdominal muscles and lumbar paraspinal muscles without needle EMG examination of corresponding limb muscles."