Neurology & Pain Management Coding Alert

Question: What code should I report for vagal nerve stimulator (VNS) testing only?

Colorado Subscriber

Answer: CPT includes several codes for nerve stimulator analysis, but most include programming. If your neurologist tests the stimulator but doesn't reprogram it or make other changes, report 95970 (Electronic analysis of implanted neurostimulator pulse generator system [e.g., rate, pulse amplitude and 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, autonomic nerve, neuromuscular] neurostimulator pulse generator/transmitter, without reprogramming).

Although you should report whatever diagnosis your physician documents, carriers often limit the payable diagnoses for 95970. Acceptable options usually include:

• 345.41 -- Localization-related (focal) (partial) epilepsy and epileptic syndromes with complex partial seizures; with intractable epilepsy
• 345.51 -- Localization-related (focal) (partial) epilepsy and epileptic syndromes with simple partial seizures; with intractable epilepsy
• 345.91 -- Epilepsy, unspecified; with intractable epilepsy
• 780.39 -- Other convulsions.