Neurology & Pain Management Coding Alert

Terminology Checkpoint:

Verify That You Understand Autonomic Testing Terms

Published on Fri Nov 28, 2014

Here’s your handy rundown of important terms.

In order to understand autonomic testing codes and report them correctly, you might need a refresher on medical terminology.

“Autonomic nervous system” (ANS) is the part of the nervous system that controls involuntary activities, such as blood pressure and heart beat. The ANS consists of a network of nerves divided into two parts: parasympathetic nervous system and sympathetic nervous system. The two systems act together, and normally, balance each other. The parasympathetic system predominates during times of relaxation, acting to conserve and restore energy. The sympathetic nervous system prepares the body to cope, during times of stress.
“Beat-to-beat recording” means the patient’s heart rate and/or blood pressure is recorded at every heartbeat.
“Valsalva maneuver” (referenced in the 95921, 95922 and 95943 code descriptions) is performed by attempting to forcibly exhale while keeping the mouth and nose closed.
“Tilt table test” (as referred to in codes 95922 and 95924) helps the physician learn what might be causing the patient’s unexplained fainting. During the test, the patient lies on a table that moves from a horizontal to a vertical position. The physician monitors the patient’s heart rate and blood pressure on a minute-by-minute basis while the table is tilted in a head-up position at different levels.
“Passive tilt” (referenced in the 95922 and 95924 code descriptions) is performed by placing a patient on a tilt table, obtaining a baseline recording, and then tilting the angle of the table to 60-80 degrees for at least 5 minutes.

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