Neurology & Pain Management Coding Alert
Cranial Nerve EMG
Question: What are the requirements for reporting cranial nerve EMGs 95867 and 95868? Is there a minimum number of muscles the physician must test to use these codes? Neurology Discussion Group Participant
Cranial Nerve EMG Answer: CPT defines 95867 as "Needle electromyography [EMG], cranial nerve supplied muscles, unilateral," with 95868 as the bilateral equivalent of the same procedure. Per guidelines cited in the April 2002 CPT Assistant, "Code 95867 is used for the needle examination of one or more muscles supplied by cranial nerves on one side of the body. Code 95868 is used for the needle examination of one or more muscles supplied by cranial nerves on both sides of the body. These codes should not be reported together. The physician's report should identify the muscles tested." When reporting a unilateral procedure, you may wish to append modifiers -LT (Left side) and/or -RT (Right side), as appropriate, to enhance the specificity of your claim. In all cases, the number of tests should be the minimum necessary to confirm a diagnosis or differentiate between diseases, and documentation must support medical necessity for the test.
answer.
There is no minimum number of muscles the physician must test: You may report the codes for any and all muscles studied that are supplied by a particular cranial nerve. As with other EMG procedures, the tests are conducted with the muscles at rest and at various levels of contraction.
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