Neurology & Pain Management Coding Alert

Question: Our neurologist completed a repetitive nerve stimulation test with ADM stimulation via the ulnar nerve and Trapezius stimulation via the XI cranial nerve. He was testing for myasthenia gravis. How I should code this testing for billing?

Oregon Subscriber

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

Notice that the code description includes the term “each nerve,” which can sometimes confuse coders. Submit 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: Suppose three separate and distinct nerves were repetitively stim tested -- 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.

In your case of testing the ulnar nerve and the accessory nerve (cranial nerve XI), the appropriate choice is 95937 with 2 units of service. That’s because you base the coding on the total number of individual nerves tested, not the number of repetitive stimulations performed on each nerve.