Eli's Rehab Report

Question: I am having problems with Medicare not paying for CPT 95920 . The carrier says I need to bill this code with the procedure that my physiatrist performed. Our physiatrists, however, are just doing the monitoring, not the actually surgery. How should I address this issue?


Montana Subscriber

Answer: Code +95920 (Intraoperative neurophysiology testing, per hour [list separately in addition to code for primary procedure]) is an "add-on" code, which means you cannot report it by itself.

Look in your CPT book and read the notes following 95920's descriptor. They include a list of CPT codes that you can use as the primary code(s). For example, you might report 95920 in addition to other monitoring procedures, such as lower-extremity SSEP (95926, Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs).

You Be the Coder and Reader Questions were reviewed by Marvel Hammer, RN, CPC, CCS-P, CHCO, owner of MJH Consulting in Denver.