How To Use CPT Code 95911

CPT 95911 refers to nerve conduction studies involving 9-10 studies, a diagnostic test to evaluate the function of motor and sensory nerves in the human body. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT code 95911.

1. What is CPT 95911?

CPT 95911 is a code used to describe a diagnostic procedure that involves the evaluation of the electrical conduction ability of motor and sensory nerves in the human body. This test is performed to determine the site of nerve damage and destruction. The code is specifically used when the provider performs 9-10 nerve conduction studies.

2. 95911 CPT code description

The official description of CPT code 95911 is: “Nerve conduction studies; 9-10 studies.”

3. Procedure

The 95911 procedure involves the following steps:

  1. Preparation of the patient for the nerve conduction study.
  2. Placement of two electrodes on the nerve to be tested.
  3. Stimulation of the nerve with a mild electrical impulse using one electrode.
  4. Recording of the resulting electrical activity of the nerve using the other electrode.
  5. Repetition of the procedure for each of the 9-10 nerves being tested.
  6. Analysis of the recorded electrical activity as a waveform on a computer by the provider.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 95911 services are those experiencing symptoms or conditions that suggest nerve damage or dysfunction. These may include, but are not limited to, peripheral neuropathy, carpal tunnel syndrome, radiculopathy, and other nerve-related disorders. The provider must determine the necessity of performing 9-10 nerve conduction studies based on the patient’s clinical presentation and medical history.

5. When to use CPT code 95911

It is appropriate to bill the 95911 CPT code when the provider performs 9-10 nerve conduction studies on a patient who has symptoms or conditions suggesting nerve damage or dysfunction. The provider must determine the necessity of performing this number of studies based on the patient’s clinical presentation and medical history.

6. Documentation requirements

To support a claim for CPT 95911, the following information needs to be documented:

  • Patient’s medical history and clinical presentation.
  • Indication for performing 9-10 nerve conduction studies.
  • Details of the procedure, including the nerves tested and the results of each study.
  • Interpretation and analysis of the recorded waveforms by the provider.
  • Provider’s conclusions and recommendations based on the results of the studies.

7. Billing guidelines

When billing for CPT code 95911, keep in mind the following guidelines:

  • Report nerve conduction study codes based on the number of studies performed.
  • Append professional component modifier 26 if reporting only the professional component for the service.
  • Append technical component modifier TC if reporting only the technical component for the service, unless the hospital provided the technical component.
  • Do not append a professional or technical modifier when reporting a global service in which one provider renders both the professional and technical components.

8. Historical information

CPT 95911 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates since its addition.

9. Similar codes to CPT 95911

Five similar codes to CPT 95911 and how they differentiate are:

  • CPT 95905: Involves motor and/or sensory nerve conduction using preconfigured electrode array(s).
  • CPT 95907: Involves 1-2 nerve conduction studies.
  • CPT 95908: Involves 3-4 nerve conduction studies.
  • CPT 95909: Involves 5-6 nerve conduction studies.
  • CPT 95910: Involves 7-8 nerve conduction studies.

10. Examples

Here are 10 detailed examples of CPT code 95911 procedures:

  1. A patient with suspected peripheral neuropathy due to diabetes undergoes 10 nerve conduction studies to evaluate the extent of nerve damage.
  2. A patient with a history of carpal tunnel syndrome in both wrists undergoes 9 nerve conduction studies to assess the severity of the condition.
  3. A patient with suspected radiculopathy in the cervical and lumbar spine undergoes 10 nerve conduction studies to determine the affected nerve roots.
  4. A patient with a history of chemotherapy-induced peripheral neuropathy undergoes 9 nerve conduction studies to monitor the progression of the condition.
  5. A patient with symptoms of polyneuropathy undergoes 10 nerve conduction studies to evaluate the involvement of multiple nerves.
  6. A patient with suspected Guillain-Barré syndrome undergoes 9 nerve conduction studies to assess the extent of nerve damage and monitor the response to treatment.
  7. A patient with a history of nerve injury due to trauma undergoes 10 nerve conduction studies to evaluate the recovery of nerve function.
  8. A patient with suspected multiple sclerosis undergoes 9 nerve conduction studies to assess the involvement of peripheral nerves in the disease process.
  9. A patient with symptoms of peripheral nerve entrapment undergoes 10 nerve conduction studies to identify the affected nerves and guide treatment planning.
  10. A patient with a history of chronic inflammatory demyelinating polyneuropathy undergoes 9 nerve conduction studies to monitor the response to immunotherapy.

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