How To Use CPT Code 95913

CPT 95913 refers to nerve conduction studies involving 13 or more studies, and this article will discuss its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 95913?

CPT 95913 is a medical billing code used for nerve conduction studies involving 13 or more studies. These diagnostic tests evaluate the function and electrical conduction ability of motor and sensory nerves in the human body. The code is used by medical coders and billers to accurately document and bill for this specific procedure.

2. 95913 CPT code description

The official description of CPT code 95913 is: “Nerve conduction studies; 13 or more studies.”

3. Procedure

1. The patient is appropriately prepared for the procedure.
2. Two electrodes are placed on the nerve to be tested.
3. One electrode stimulates the nerve with a mild electrical impulse, while the other records the resulting electrical activity.
4. The procedure is repeated for each nerve being tested, totaling 13 or more studies.
5. The electrical activity is recorded as a waveform on a computer and analyzed by the provider.
6. Different types of nerve conduction studies are performed, including motor nerve conduction study, sensory nerve conduction study, F waves, and H reflex.

4. Qualifying circumstances

Patients eligible to receive CPT code 95913 services are those who require diagnostic testing to evaluate the function and electrical conduction ability of their motor and sensory nerves. This may include patients with symptoms or conditions such as neuropathy, nerve compression, nerve injury, or other nerve-related disorders.

5. When to use CPT code 95913

It is appropriate to bill the 95913 CPT code when a provider performs 13 or more nerve conduction studies on a patient to diagnose or evaluate nerve function and electrical conduction ability. This code should be used when the provider has determined that a comprehensive evaluation of the patient’s nerves is necessary.

6. Documentation requirements

To support a claim for CPT 95913, the following information should be documented:

• Patient’s medical history and symptoms related to nerve function.
• Physical examination findings relevant to the patient’s nerve function.
• Specific nerves tested and the reason for testing each nerve.
• Results of each nerve conduction study, including latency, conduction velocity, and amplitude.
• Provider’s interpretation of the test results and any relevant clinical correlation.
• Treatment plan or recommendations based on the test results.

7. Billing guidelines

When billing for CPT code 95913, follow these 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.
• Do not report CPT codes 95905, 95907, 95908, 95909, 95910, 95911, 95912, or 95913 for noninvasive nerve conduction guidance used in conjunction with 0766T or 0768T.

8. Historical information

CPT 95913 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 95913

Five similar codes to CPT 95913 and how they differentiate are:

• CPT 95905: Nerve conduction study with limited studies, typically used for less complex cases.
• CPT 95907: Nerve conduction studies with 1-2 studies, used for a more focused evaluation of nerve function.
• CPT 95908: Nerve conduction studies with 3-4 studies, used when a few specific nerves need to be evaluated.
• CPT 95909: Nerve conduction studies with 5-6 studies, used for a more comprehensive evaluation of nerve function.
• CPT 95912: Nerve conduction studies with 11-12 studies, used when a nearly complete evaluation of nerve function is required.

10. Examples

Here are 10 detailed examples of CPT code 95913 procedures:

1. A patient with suspected carpal tunnel syndrome in both hands requires a comprehensive evaluation of their median, ulnar, and radial nerves.
2. A patient with diabetic neuropathy experiencing sensory loss in both feet requires evaluation of multiple sensory nerves in the lower extremities.
3. A patient with a history of nerve injury following a traumatic accident requires evaluation of multiple nerves in the affected limb.
4. A patient with suspected Guillain-Barré syndrome requires a comprehensive evaluation of motor and sensory nerves in both upper and lower extremities.
5. A patient with unexplained muscle weakness and sensory loss requires a comprehensive evaluation of multiple nerves to determine the cause.
6. A patient with suspected chronic inflammatory demyelinating polyneuropathy requires evaluation of multiple motor and sensory nerves in both upper and lower extremities.
7. A patient with a history of chemotherapy treatment experiencing peripheral neuropathy symptoms requires evaluation of multiple nerves to assess the extent of nerve damage.
8. A patient with suspected multiple sclerosis experiencing sensory and motor symptoms requires a comprehensive evaluation of multiple nerves to assess the extent of nerve involvement.
9. A patient with a suspected hereditary neuropathy requires a comprehensive evaluation of multiple nerves to determine the pattern of nerve involvement.
10. A patient with suspected nerve compression in multiple locations requires a comprehensive evaluation of the affected nerves to determine the extent of nerve damage and plan appropriate treatment.