Neurology & Pain Management Coding Alert

Question: What is the best way to code for somatosensory evoked potential testing using the posterior tibial nerve and occasionally the peroneal nerve? I feel that the right to left comparison is essential, but many carriers tell me that only one charge will be paid.

Richard Curtis
Somerset, N.J.

Answer: The most common questions concern the numbers of units of the codes that can be used when multiple nerves or dermatomes (skin sites) are stimulated in a given limb, says Neil A. Busis, MD, chief of the division of neurology and director of the neurodiagnostic laboratory at the University of Pittsburgh Medical Center at Shadyside in Pittsburgh and president of the American Association of Electrodiagnostic Medicine (AAEM). Only one unit of 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) can be used regardless of the number of nerves or dermatomes that are stimulated in each upper limb (on one or both sides). Similarly, only one unit of 95926 (short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs) can be used regardless of the number of nerves or dermatomes that are stimulated in each lower limb (on one or both sides).

Note that the codes are defined as bilateral codes. Modifier -52 must be used for unilateral studies.