Neurology & Pain Management Coding Alert

Reader Questions:

Stay With 1 Unit of 95925/95926

Question: May I report one unit of 95925 for each site the neurologist tests?

Idaho Subscriber

 Answer: You should 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) no matter how many skin sites (dermatomes) the neurologist tests.
 
And, the neurologist is not required to test a minimum number of sites to report 95925-95927 (note the use of the term "any/all" in the descriptors).
 
Be aware, however, that CPT defines 95925-95926 as bilateral codes, as indicated by "limbs" in the descriptor. Therefore, if you test on one side only, you must append modifier -52 (Reduced services) to the appropriate code.

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