How To Use CPT Code 95874

CPT 95874 describes the use of needle electromyography for guidance in conjunction with chemodenervation. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 95874?

CPT 95874 can be used to describe the use of needle electromyography for guidance during a chemodenervation injection. This procedure involves injecting a neurotoxin, such as ethyl alcohol or Botox®, into nerves that supply muscles to reduce spasticity and treat neurological disorders. The provider uses needle electromyography to measure muscle response and localize the specific muscles to be treated.

2. Official Description

The official description of CPT code 95874 is: ‘Needle electromyography for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure).’ This code should be used in conjunction with primary codes for chemodenervation procedures. It should not be reported with certain other codes, such as those for nerve blocks or other electromyography services.

3. Procedure

1. The provider uses needle electromyography to measure muscle response or electrical activity in response to nerve stimulation.
2. Using the guidance provided by needle electromyography, the provider administers a chemodenervation injection, such as ethyl alcohol or Botox®, into the nerves supplying the targeted muscles.
3. This injection helps reduce spasticity and treat neurological disorders by immobilizing the overactive muscles.

4. Qualifying circumstances

CPT 95874 is used when needle electromyography is used to guide a chemodenervation injection. This procedure is typically performed to treat conditions such as spasmodic torticollis, dystonia, and other movement disorders. It is important to note that this code should only be reported once per reportable chemodenervation service and should not be reported with certain other codes, such as those for nerve blocks or other electromyography services.

5. When to use CPT code 95874

CPT code 95874 should be used when needle electromyography is used to guide a chemodenervation injection. It is important to ensure that the appropriate primary code for the chemodenervation procedure is also reported in conjunction with CPT 95874. This code should not be reported with certain other codes, as mentioned in the official description.

6. Documentation requirements

To support a claim for CPT 95874, the provider must document the following information:

• The specific chemodenervation procedure performed
• The use of needle electromyography for guidance during the procedure
• Date and time of the procedure
• Details of the muscles targeted and the neurotoxin used
• Any additional relevant information or findings

7. Billing guidelines

When billing for CPT 95874, it is important to ensure that the appropriate primary code for the chemodenervation procedure is also reported. This code should not be reported with certain other codes, such as those for nerve blocks or other electromyography services. If reporting only the professional component, modifier 26 should be appended to the code. If reporting only the technical component, modifier TC should be appended, unless the hospital provided the technical component.

8. Historical information

CPT 95874 was added to the Current Procedural Terminology system on January 1, 2006. There have been no updates to the code since its addition.

9. Examples

1. A provider uses needle electromyography to guide the injection of Botox® into the nerves supplying the muscles of a patient with spasmodic torticollis.
2. Using needle electromyography, a provider administers an ethyl alcohol injection into the nerves supplying the overactive muscles of a patient with dystonia.
3. During a chemodenervation procedure, a provider uses needle electromyography to guide the injection of Botox® into the muscles of a patient with a movement disorder.
4. A provider performs needle electromyography to localize the specific muscles to be treated and then administers a chemodenervation injection to reduce spasticity in a patient with a neurological disorder.
5. Using needle electromyography, a provider guides the injection of a neurotoxin into the nerves supplying the muscles of a patient with spasticity.
6. A provider uses needle electromyography to measure muscle response and guide the injection of a neurotoxin into the targeted muscles of a patient with a movement disorder.
7. During a chemodenervation procedure, a provider uses needle electromyography to guide the injection of a neurotoxin into the muscles of a patient with spasticity.
8. A provider administers a chemodenervation injection, guided by needle electromyography, to reduce spasticity in the muscles of a patient with a neurological disorder.
9. Using needle electromyography, a provider localizes the specific muscles to be treated and then administers a chemodenervation injection to reduce spasticity in a patient with a movement disorder.
10. A provider performs needle electromyography to measure muscle response and guide the injection of a neurotoxin into the targeted muscles of a patient with spasticity.