Neurology & Pain Management Coding Alert

Question: When counting nerve conduction studies to choose the appropriate CPT® code, the guideline states, “Each nerve constitutes one unit of service.” So do we only count to nerves listed or can we also count the branches listed? 

Illinois Subscriber

Answer: Appendix J of the CPT® manual does indicate that “Each nerve constitutes one unit of service.” However, a nerve is defined as a separate nerve branch. For example, a nerve conduction study (NCS) of the median sensory nerve to the first digit is separate from an NCS of the median sensory nerve to the second digit. Testing of both of these median nerve branches would be counted as a total of two studies, not one.  

According to the November 2008 CPT® Assistant, “Another specific example of two distinct branches of a sensory nerve is testing performed on the ulnar sensory nerve (stimulate on anterior aspect of wrist, record from the fifth digit [I.G.3]). Another branch is the dorsal cutaneous branch of the ulnar sensory nerve (I.G.1.), which is tested by stimulating above the wrist on the posterior aspect of the wrist and recording from the dorsum of the hand.” 

The codes for NCS changed to 95905-95913 in 2013, but the coding methodology as to what constitutes a separate nerve remained the same. 

Remember: Appendix J of CPT® includes all the motor, sensory, and mixed nerves that might be treated during a nerve conduction study. The nerves are listed by letter in conjunction with their corresponding branches (noted by Roman numerals).