Neurology & Pain Management Coding Alert

Question: When we perform orbicularis oculi (blink) reflex by electrodiagnostic testing (95933), should we bill multiple units for testing both eyes? What about modifiers -50 or -LT, -RT?

Washington Subscriber

Answer: Code 95933 (Orbicularis oculi [blink] reflex, by electrodiagnostic testing) is inherently bilateral, according to CMS guidelines. And, the CPT descriptor includes the plural term "oculi," referring to both eyes. Therefore, you should not report multiple units when testing both eyes, nor should you append -50 (Bilateral procedure). And, because the code is by definition bilateral, you needn't report modifiers -LT (Left side) or -RT (Right side) to differentiate the testing sites.

Should the neurologist only test one eye, however, you should append modifier -52 (Reduced services) to 95933. In this case, you may also choose to append modifier -LT or -RT, as appropriate, to indicate which eye the neurologist studied.