Neurology & Pain Management Coding Alert

Question: A neurologist performs evoked potentials on patients. How many units of these codes (95925-95927) can I bill when multiple nerves or skin sites are stimulated in a given limb? Also, how many peripheral nerves or skin sites must be tested?

Maryland Subscriber

Answer: The codes for evoked potentials 95925 (short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs), 95926 (... in lower limbs) and 95927 (... in the trunk or head) can be billed only as one unit regardless of the number of nerves or dermatomes (skin sites) that are stimulated in each upper limb (on one or both sides). Similarly, only one unit of 95926 can be used regardless of the number of nerves or dermatomes that are stimulated in each lower limb (on one or both sides). Coders should also note that these codes are defined as bilateral, which means modifier -52 (reduced services) must be used for unilateral studies.