Neurology & Pain Management Coding Alert

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: Our neurologist performed evoked potentials at three sites on the patient's arm. I reported 95925 x 3 with modifier -51 attached to the second and third code, but the claim was denied. How should I have coded? Texas Subscriber     Answer: Evoked potentials codes, including 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), 95926 ( in lower limbs) and 95927 ( in the trunk or head), should be reported only once per session, regardless of the number of nerves or skin sites tested. Do not report multiple units with modifier -51 (Multiple procedures) attached. The code descriptors for evoked potentials already specify "any/all peripheral nerves or skin sites."

Codes 95925-95927 are inherently bilateral codes. Therefore, if testing is provided on only one limb (e.g., arm or leg), modifier -52 (Reduced services) should be attached to the appropriate evoked potential code.

For example, if the neurologist tests three sites on the left leg and three sites on the right leg, report 95926. If the neurologist tests five sites on the left leg and no sites on the right leg, use 95926-52.