Neurology & Pain Management Coding Alert

Question: The neurologist completed repetitive nerve stimulation tests with ADM stimulation via the ulnar nerve and trapezius stimulation via the XI cranial (Accessory) nerve. How I should code this testing?

Kentucky Subscriber

Answer: For neuromuscular junction (NMJ) testing, report 95937 (Neuromuscular junction testing [repetitive stimulation, paired stimuli], each nerve, any one method). Repetitive stimulation studies identify and differentiate disorders of the NMJ, such as myasthenia gravis (358.0x).

The code descriptor includes the term “each nerve,” and that’s where trouble often begins. Coding is based on the total separate and distinct nerves, not the total number of stimulations. You should report 95937 as a single line item with the total number of separate and distinct nerves tested reported in box 24G or its electronic equivalent).

Example: The neurologist performed repetitive stimulation tests on three separate and distinct nerves – the ulnar motor nerve to the abductor digiti minimi muscle, the median motor nerve to the abductor pollicis brevis muscle, and the spinal accessory nerve to the upper trapezius muscle. You should report a single line item of 95937 with “3” in the units field.