Neurology & Pain Management Coding Alert

Question: The neurologist that I bill for performs intraoperative monitoring (IOM). Is there a limit on the units of service that can I bill for the baseline diagnostic study codes?

North Dakota Subscriber

Answer: According to the CPT parenthetical note with +95920 (Intraoperative neurophysiology testing, per hour [List separately in addition to code for primary procedure]), you should use this add-on code once per hour even if the physician performs multiple electrophysiologic studies.

You should report the baseline electrophysiologic study(s) once per operative session.

Look Out: One exception would be if the neurologist is not performing all the requirements for complete needle extremity electromyography (EMG) studies, but rather only limited (EMG) studies.

In this case, your neurologist could report one unit of 95870 (Needle electromyography; limited study of muscles in one extremity or non-limb [axial] muscles [unilateral or bilateral], other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters) for each separate and distinct limited baseline EMG study performed.

For example: You would code a limited EMG of the right lower extremity (RLE) and the left lower extremity (LLE) as two units of 95870.

This exception is supported by a Q&A in the June 2005 issue of the AMA's CPT Assistant addressing pedicle screw stimulation.