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: What is the proper code(s) to report Tensilon tests?

Texas Subscriber

 Answer: The proper code is 95857 (Tensilon test for myasthenia gravis) or, if electromyography is performed at the same time, 95858 ( with electromyographic recording).
 
Tensilon testing is a diagnostic procedure performed in the office or hospital to help differentiate causes of weakness, double vision and drooping eyelids, such as when myasthenia gravis (358.0) is suspected. The physician performs the test by injecting Tensilon (edrophonium chloride) into a vein and comparing the patient's strength before and after administration. Tensilon improves muscle strength by increasing muscular response to nerve impulses. Effects of the drug last about 10 minutes or less. The test is considered positive when there is a definite improvement in the patient's strength.
 
Generally accepted ICD-9 codes for Tensilon testing include:

  368.2 Diplopia
  374.30 Ptosis of eyelid, unspecified
  378.73 Strabismus in other neuromuscular disorders
  728.9 Unspecified disorder of muscle, ligament, and fascia
  780.7 Malaise and fatigue
  784.5 Other speech disturbance
  786.09 Symptoms involving respiratory system and other chest symptoms, other
  787.2 Dysphagia.
Check with your carrier for a complete list of acceptable diagnoses.