How To Use CPT Code 90913

CPT 90913 describes the procedure for biofeedback training of the perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when performed. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 90913?

CPT 90913 can be used to describe the procedure for biofeedback training of the perineal muscles, anorectal or urethral sphincter. This code includes the use of electromyography (EMG) and/or manometry, if performed, to assist in training the patient to control involuntary bodily functions. The training aims to alter brain activity, blood pressure, heart rate, and other bodily functions that the patient cannot normally control voluntarily. This service is typically provided for conditions such as fecal or urinary incontinence.

2. Official Description

The official description of CPT code 90913 is: ‘Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when performed; each additional 15 minutes of one-on-one physician or other qualified health care professional contact with the patient (List separately in addition to code for primary procedure).’ This code should be used in conjunction with code 90912 for the first 15 minutes of face-to-face biofeedback training, and code 90913 should be reported for each additional 15 minutes of training.

3. Procedure

1. The provider begins with an initial 15 minutes of face-to-face biofeedback training with the patient.
2. After the initial training, the provider continues with biofeedback-assisted pelvic muscle education (PME) using techniques such as electromyography (EMG) and/or manometry.
3. The provider helps the patient become more aware of their pelvic muscles and assists in their movement.
4. The service may also include other techniques, such as relaxation, to help control involuntary bodily movements.
5. The provider documents the testing results and their interpretation in the patient’s medical record.
6. For each additional 15 minutes of face-to-face biofeedback training after the initial 15 minutes, code 90913 should be reported.

4. Qualifying circumstances

CPT 90913 is used for patients who require biofeedback training for conditions such as fecal or urinary incontinence. The training focuses on the perineal muscles, anorectal or urethral sphincter. The use of electromyography (EMG) and/or manometry may be included in the training. The provider must have face-to-face contact with the patient and use biofeedback-assisted pelvic muscle education (PME) techniques to help the patient control their involuntary bodily functions.

5. When to use CPT code 90913

CPT code 90913 should be used when a provider performs biofeedback training for the perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, for each additional 15 minutes of face-to-face training. This code should be used in conjunction with code 90912 for the first 15 minutes of training.

6. Documentation requirements

To support a claim for CPT 90913, the provider must document the following information:

• Reason for biofeedback training and the specific condition being treated
• Details of the biofeedback-assisted pelvic muscle education (PME) techniques used
• Date, start and end time of each 15-minute face-to-face training session
• Results of any electromyography (EMG) and/or manometry performed
• Progress made by the patient and any additional sessions scheduled
• Signature of the provider performing the service

7. Billing guidelines

When billing for CPT 90913, ensure that the provider has performed the biofeedback training for the perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry. Use code 90912 for the first 15 minutes of training and code 90913 for each additional 15 minutes of training. It is important to note that some payers may require the modifier GP to indicate that the services were delivered under an outpatient physical therapy plan of care.

8. Historical information

CPT 90913 was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates to the code since its addition.

9. Examples

1. A provider performs biofeedback training for a patient with fecal incontinence, including EMG and manometry, for an additional 15 minutes of face-to-face training.
2. A provider continues biofeedback training for a patient with urinary incontinence, including EMG, for an additional 15 minutes of face-to-face training.
3. A provider performs biofeedback training for a patient with anorectal dysfunction, including manometry, for an additional 15 minutes of face-to-face training.
4. A provider conducts biofeedback training for a patient with pelvic floor dysfunction, including EMG and manometry, for an additional 15 minutes of face-to-face training.
5. A provider continues biofeedback training for a patient with urethral sphincter dysfunction, including EMG, for an additional 15 minutes of face-to-face training.
6. A provider performs biofeedback training for a patient with pelvic pain, including manometry, for an additional 15 minutes of face-to-face training.