Neurology & Pain Management Coding Alert

Reader Question:

Use 95925 Only Once per Session

Question: I've heard conflicting advice regarding the use of 95925. May I report multiple units if I test four or more dermatomes? What is the minimum number of dermatomes required to report 95925?

Kansas Subscriber

Answer: You may report only a single 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) or its companion codes 95926 ( in lower limbs) and 95927 (... in the trunk or head), regardless of the number of skin sites (dermatomes) tested. By the same token, there is no minimum number of sites for 95925-95927 (note the use of the term "any/all" in the descriptors). Be aware, however, that 95925-95926 are bilateral codes, as indicated by the use of "limbs" in the descriptor. Therefore, if you test on one side only, you must append modifier -52 (Reduced services).

Clinical and coding expertise for You Be the Coder and Reader Questions provided by Neil Busis, MD, chief of the division of neurology and director of the neurodiagnostic laboratory at the University of Pittsburgh Medical Center at Shadyside, and clinical associate professor in the department of neurology, University of Pittsburgh School of Medicine; and Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, director and senior instructor for CRN Institute, an online coding certification training center based in Absecon, N.J.

 

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