Neurology & Pain Management Coding Alert

Question: Encounter notes indicate that the physician performed an autonomic function test. What is the code for this service?

Illinois Subscriber

Answer: It depends on the type of autonomic function test the physician administers. There are several codes to represent the test, and all of the codes represent very different test parameters. In fact, it might be a good idea to get detailed information on each type of autonomic function test so you know what to look for in the notes.

For now, you should go back and look at the notes and choose one of the following codes based on encounter specifics:

• 95921 (Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded R-R interval, Valsalva ratio, and 30:15 ratio)
• 95922 (… vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and R-R interval changes during Valsalva maneuver and at least 5 minutes of passive tilt)
• 95923 (… sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (QSART), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential)
• 95924 (… combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt).