How To Use CPT Code 95865

CPT 95865 describes the procedure of needle electromyography for the larynx. 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 95865?

CPT 95865 is used to describe the procedure of needle electromyography specifically for the larynx. This code is utilized when a healthcare provider inserts needles with wire electrodes into the muscles of the larynx to record the electrical activity produced by the muscle cells. The provider can then listen to the recordings on a loudspeaker to assess the muscle function and diagnose any neuromuscular laryngeal disorders.

2. Official Description

The official description of CPT code 95865 is: ‘Needle electromyography; larynx.’

3. Procedure

1. During the procedure, the healthcare provider inserts a needle with wire electrodes through the skin and into the deeper layers of the larynx.
2. The provider then carefully inserts the electrode into the laryngeal muscles while monitoring the electrical activity produced by the muscle cells.
3. The recordings of the electrical activity are heard on a loudspeaker, allowing the provider to assess the muscle function and diagnose any neuromuscular laryngeal disorders.

4. Qualifying circumstances

CPT 95865 is performed when a healthcare provider needs to diagnose neuromuscular laryngeal disorders. The procedure involves inserting needles with wire electrodes into the muscles of the larynx to record the electrical activity. It is important to note that modifier 50 should not be reported with CPT 95865, and if the procedure is performed unilaterally, modifier 52 should be appended.

5. When to use CPT code 95865

CPT code 95865 should be used when a healthcare provider needs to perform needle electromyography specifically for the larynx. It is important to ensure that the procedure is necessary for diagnosing neuromuscular laryngeal disorders. This code should not be used for any other electromyography procedures or for different anatomical areas.

6. Documentation requirements

To support a claim for CPT 95865, the healthcare provider must document the following information:

• Reason for performing the procedure and the suspected neuromuscular laryngeal disorder
• Date and time of the procedure
• Details of the procedure, including the insertion of needles with wire electrodes into the laryngeal muscles
• Recordings of the electrical activity and the provider’s interpretation
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 95865, it is important to ensure that the procedure is performed by a qualified healthcare provider. Modifier 26 should be appended if only the physician’s interpretation is being reported, and modifier TC should be appended if only the technical component is being reported. However, if the provider renders both the professional and technical components, no modifier should be appended. It is also important to follow any specific guidelines provided by the payer regarding the reporting of CPT 95865.

8. Historical information

CPT 95865 was added to the Current Procedural Terminology system on January 1, 2006. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider performing needle electromyography for the larynx to diagnose a patient with vocal cord paralysis.
2. A specialist inserting needles with wire electrodes into the laryngeal muscles to assess the muscle function of a patient with suspected neuromuscular laryngeal disorder.
3. A physician performing needle electromyography specifically for the larynx to evaluate a patient with voice hoarseness.
4. A healthcare provider using needle electromyography to diagnose a patient with spasmodic dysphonia by assessing the electrical activity of the laryngeal muscles.
5. A specialist performing needle electromyography for the larynx to evaluate a patient with difficulty swallowing due to suspected neuromuscular laryngeal disorder.
6. A healthcare provider utilizing needle electromyography to assess the muscle function of the larynx in a patient with vocal cord nodules.
7. A physician performing needle electromyography specifically for the larynx to diagnose a patient with muscle tension dysphonia.
8. A specialist inserting needles with wire electrodes into the laryngeal muscles to evaluate a patient with suspected neuromuscular laryngeal disorder causing voice changes.
9. A healthcare provider using needle electromyography to assess the muscle function of the larynx in a patient with vocal cord polyps.
10. A specialist performing needle electromyography for the larynx to diagnose a patient with vocal cord paresis.