Neurology & Pain Management Coding Alert

Question: Our neurologist completed a Tensilon test, but I couldn't find the medication listed in HCPCS. Is the medication included in the procedure code?

North Carolina Subscriber

Answer: Physicians often inject Tensilon or edrophonium chloride during a Tensilon test. According to the HCPCS Table of Drugs, report J3490 (Unclassified drugs) for 10 mg/mL of edrophonium chloride.

Procedure: Submit 95857 (Tensilon test for myasthenia gravis) for the test itself. A Tensilon test involves careful observation the patient after your provider administers Tensilon by IV. The medication is a rapid, short-acting anticholinesterase that improves muscle strength by increasing muscle response to nerve impulses.