How To Use CPT Code 95941

CPT 95941 refers to continuous intraoperative neurophysiology monitoring during brain surgery, performed by a qualified healthcare provider other than the surgeon or anesthesia staff. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT code 95941.

1. What is CPT 95941?

CPT 95941 is a medical billing code used to report continuous intraoperative neurophysiology monitoring during brain surgery. This monitoring is performed by a qualified healthcare provider other than the surgeon or anesthesia staff to ensure the proper functioning of the patient’s nervous system during the surgical procedure. The code represents each hour of the service and can be billed in conjunction with an appropriate primary code for the type of neurophysiology test performed.

2. 95941 CPT code description

The official description of CPT code 95941 is: “Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby) or for monitoring of more than one case while in the operating room, per hour (List separately in addition to code for primary procedure)”.

3. Procedure

The 95941 procedure involves the following steps:

1. A qualified healthcare provider, other than the surgeon or anesthesia staff, prepares to perform continuous intraoperative neurophysiology monitoring during brain surgery.
2. The provider selects the appropriate neurophysiology test(s) to be performed, such as EEG, EMG, evoked potentials, or nerve conduction study.
3. The provider sets up the necessary equipment and ensures proper functioning before the surgery begins.
4. During the surgery, the provider continuously monitors the patient’s nervous system function using the selected test(s).
5. The provider may be located outside the operating room (remote or nearby) or may be monitoring more than one case while in the operating room.
6. The provider documents the monitoring process and any relevant findings for each hour of service.

4. Qualifying circumstances

Eligibility for CPT code 95941 services depends on the following qualifying circumstances:

• The monitoring must be performed by a qualified healthcare provider other than the surgeon or anesthesia staff.
• The provider must be personally attending the monitoring process, meaning it cannot be done by the anesthesia staff or the surgeon.
• The monitoring must be continuous throughout the surgical procedure.
• The provider may be located outside the operating room (remote or nearby) or may be monitoring more than one case while in the operating room.
• An appropriate primary code for the type of neurophysiology test performed must be billed in conjunction with CPT code 95941.

5. When to use CPT code 95941

It is appropriate to bill the 95941 CPT code when a qualified healthcare provider, other than the surgeon or anesthesia staff, performs continuous intraoperative neurophysiology monitoring during brain surgery to ensure the proper functioning of the patient’s nervous system. The code should be billed for each hour of monitoring during the operation and must be used in conjunction with an appropriate primary code for the type of neurophysiology test performed.

6. Documentation requirements

To support a claim for CPT 95941, the following information must be documented:

• The name and credentials of the qualified healthcare provider performing the monitoring.
• The type of neurophysiology test(s) performed, such as EEG, EMG, evoked potentials, or nerve conduction study.
• The duration of the monitoring, reported in hours.
• A detailed description of the monitoring process, including any relevant findings or observations.
• Confirmation that the monitoring was continuous throughout the surgical procedure.
• Any relevant communication between the monitoring provider and the surgical team.

7. Billing guidelines

When billing for CPT code 95941, keep in mind the following guidelines and rules:

• Report the code for each hour of monitoring during the operation.
• Use CPT code 95941 in conjunction with an appropriate primary code for the type of neurophysiology test performed.
• Do not bill CPT code 95941 without an appropriate primary code, as payers will not reimburse for the service.
• Ensure that all documentation requirements are met to support the claim.

8. Historical information

CPT 95941 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Similar codes to CPT 95941

Five similar codes to CPT 95941 and how they differentiate from CPT 95941 are:

1. CPT 95955: Intraoperative EEG monitoring during nonintracranial surgery.
2. CPT 95961: Intraoperative functional cortical or subcortical mapping, first hour.
3. CPT 95962: Intraoperative functional cortical or subcortical mapping, each additional hour.
4. CPT 95938: Intraoperative neurophysiology testing, per hour, for cases not involving brain surgery.
5. CPT 95939: Intraoperative neurophysiology testing, per hour, for cases involving brain surgery but not requiring continuous monitoring.

10. Examples

Here are 10 detailed examples of CPT code 95941 procedures:

1. A patient undergoes a craniotomy for tumor resection, and a qualified healthcare provider performs continuous intraoperative neurophysiology monitoring using EEG for 4 hours.
2. A patient has a spinal fusion surgery, and a qualified healthcare provider performs continuous intraoperative neurophysiology monitoring using EMG for 3 hours.
3. A patient undergoes a deep brain stimulation implantation, and a qualified healthcare provider performs continuous intraoperative neurophysiology monitoring using evoked potentials for 5 hours.
4. A patient has a surgery for epilepsy, and a qualified healthcare provider performs continuous intraoperative neurophysiology monitoring using EEG and evoked potentials for 6 hours.
5. A patient undergoes a surgery for trigeminal neuralgia, and a qualified healthcare provider performs continuous intraoperative neurophysiology monitoring using EMG and nerve conduction study for 2 hours.
6. A patient has a surgery for brain aneurysm clipping, and a qualified healthcare provider performs continuous intraoperative neurophysiology monitoring using EEG for 3 hours.
7. A patient undergoes a surgery for arteriovenous malformation resection, and a qualified healthcare provider performs continuous intraoperative neurophysiology monitoring using evoked potentials for 4 hours.
8. A patient has a surgery for spinal cord tumor resection, and a qualified healthcare provider performs continuous intraoperative neurophysiology monitoring using EMG and nerve conduction study for 5 hours.
9. A patient undergoes a surgery for acoustic neuroma removal, and a qualified healthcare provider performs continuous intraoperative neurophysiology monitoring using EMG for 3 hours.
10. A patient has a surgery for Chiari malformation decompression, and a qualified healthcare provider performs continuous intraoperative neurophysiology monitoring using EEG and evoked potentials for 4 hours.