Neurology & Pain Management Coding Alert

Question: I am having problems with Medicare not paying for 95920. The carrier says I need to bill this code with the procedure that my neurologist performed. Our neurologists, however, are just doing the monitoring, not the surgery. How should I address this issue?

Montana Subscriber

Answer: Code +95920 (Intraoperative neurophysiology testing, per hour [list separately in addition to code for primary procedure]) is an add-on code, which means you cannot report it by itself.
 
Look in your CPT book and read the notes following 95920's descriptor. They include a list of CPT codes that you can use as the primary code(s).
 
For example, you might report 95920 in addition to other monitoring procedures, such as lower-extremity SSEP (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).

 -- 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.