CPT 95912 is a code used for nerve conduction studies involving 11-12 studies; this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.
1. What is CPT 95912?
CPT 95912 is a medical billing code used to describe a specific type of diagnostic test called nerve conduction studies. This code is specifically used when a healthcare provider performs 11-12 nerve conduction studies on a patient. Nerve conduction studies are essential for evaluating the function and electrical conduction ability of the motor and sensory nerves in the human body.
2. 95912 CPT code description
The official description of CPT code 95912 is: “Nerve conduction studies; 11-12 studies.”
The 95912 procedure involves the following steps:
- The patient is appropriately prepared for the test.
- Two electrodes are placed on the nerve to be tested.
- One electrode stimulates the nerve with a mild electrical impulse, while the other records the resulting electrical activity.
- The provider repeats this procedure for each of the 11-12 nerves being tested.
- The electrical activity is recorded as a waveform on a computer and analyzed by the provider.
- Different types of nerve conduction studies, such as motor nerve conduction study, sensory nerve conduction study, F waves, and H reflex, are performed and counted only once when multiple sites on the same nerve are stimulated or recorded.
4. Qualifying circumstances
Patients who are eligible to receive CPT code 95912 services are those experiencing symptoms or conditions that may indicate nerve damage or dysfunction. These may include, but are not limited to, the following:
- Neuromuscular disorders
- Peripheral nerve injuries
- Chronic pain syndromes
- Motor neuron diseases
5. When to use CPT code 95912
It is appropriate to bill the 95912 CPT code when a healthcare provider performs 11-12 nerve conduction studies on a patient to diagnose, evaluate, or monitor nerve function and electrical conduction ability. This code should be used when the provider has determined that this specific number of studies is necessary for a comprehensive assessment of the patient’s condition.
6. Documentation requirements
To support a claim for CPT 95912, the following information should be documented:
- Patient’s medical history and presenting symptoms
- Physical examination findings
- Indication for the nerve conduction studies
- Specific nerves tested and the rationale for their selection
- Details of the procedure, including electrode placement and stimulation parameters
- Results of the nerve conduction studies, including latency, conduction velocity, and amplitude
- Interpretation of the results and their clinical significance
- Diagnosis, treatment plan, and follow-up recommendations
7. Billing guidelines
When billing for CPT code 95912, it is essential to follow specific guidelines and rules. These include:
- Appending professional component modifier 26 when reporting only the professional component of the service
- Appending technical component modifier TC when reporting only the technical component of the service, unless the hospital provided the technical component
- Not appending 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 95912 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 95912
Five similar codes to CPT 95912 and how they differentiate are:
- CPT 95907: Nerve conduction studies with 1-2 studies
- CPT 95908: Nerve conduction studies with 3-4 studies
- CPT 95909: Nerve conduction studies with 5-6 studies
- CPT 95910: Nerve conduction studies with 7-8 studies
- CPT 95911: Nerve conduction studies with 9-10 studies
These codes differ from CPT 95912 based on the number of nerve conduction studies performed during the procedure.
Here are 10 detailed examples of CPT code 95912 procedures:
- A patient with suspected carpal tunnel syndrome undergoing 11 nerve conduction studies to evaluate median, ulnar, and radial nerve function in both upper extremities
- A patient with diabetic neuropathy undergoing 12 nerve conduction studies to assess sensory and motor nerve function in the lower extremities
- A patient with a history of chemotherapy experiencing peripheral neuropathy symptoms, undergoing 11 nerve conduction studies to evaluate the extent of nerve damage
- A patient with suspected Guillain-Barré syndrome undergoing 12 nerve conduction studies to assess the involvement of motor and sensory nerves
- A patient with a traumatic nerve injury in the upper extremity undergoing 11 nerve conduction studies to determine the extent of nerve damage and monitor recovery
- A patient with suspected chronic inflammatory demyelinating polyneuropathy undergoing 12 nerve conduction studies to evaluate the involvement of motor and sensory nerves
- A patient with a history of alcohol abuse experiencing peripheral neuropathy symptoms, undergoing 11 nerve conduction studies to assess the extent of nerve damage
- A patient with suspected Charcot-Marie-Tooth disease undergoing 12 nerve conduction studies to evaluate the involvement of motor and sensory nerves in the upper and lower extremities
- A patient with a spinal cord injury undergoing 11 nerve conduction studies to assess the extent of nerve damage and monitor recovery
- A patient with suspected myasthenia gravis undergoing 12 nerve conduction studies to evaluate neuromuscular junction function and response to treatment