How To Use CPT Code 95886

CPT 95886 is a code used for needle electromyography of each extremity with related paraspinal areas, performed with nerve conduction studies. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 95886 procedures.

1. What is CPT 95886?

CPT 95886 is a code used to describe a specific type of electromyography (EMG) procedure that involves the assessment of electrical activity in muscles of an extremity and related paraspinal areas. This procedure is performed in conjunction with nerve conduction studies, which evaluate the function of the peripheral nervous system. The code is used to report the complete study of five or more muscles innervated by three or more nerves or four or more spinal levels.

2. 95886 CPT code description

The official description of CPT code 95886 is: “Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (List separately in addition to code for primary procedure)”.

3. Procedure

The 95886 CPT code procedure involves the following steps:

1. The patient is appropriately prepped for the procedure.
2. Small needles are placed into the muscle with the muscle at rest and when the patient contracts the muscle.
3. The response of the muscle at rest and at voluntary contraction is recorded.
4. The muscle integrity is analyzed by the provider.
5. The provider assesses five or more muscles which are innervated by three or more nerves, or four or more spinal levels.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 95886 services are those who require a comprehensive assessment of the electrical activity of muscles in an extremity and related paraspinal areas, in conjunction with nerve conduction studies. This may include patients with suspected neuromuscular disorders, peripheral nerve injuries, or other conditions affecting the function of the peripheral nervous system.

5. When to use CPT code 95886

It is appropriate to bill the 95886 CPT code when a provider performs a complete needle electromyography with related paraspinal areas, studying five or more muscles innervated by three or more nerves or four or more spinal levels, in conjunction with a separately reportable nerve conduction study. This code should be used once per extremity and should be listed separately in addition to the code for the primary procedure.

6. Documentation requirements

To support a claim for CPT 95886, the following information should be documented:

• Patient’s medical history and reason for the procedure.
• Details of the procedure, including the muscles studied, nerves involved, and spinal levels assessed.
• Results of the muscle response recordings at rest and during voluntary contraction.
• Analysis of muscle integrity and any abnormalities detected.
• Interpretation of the findings and any relevant clinical correlation.

7. Billing guidelines

When billing for CPT code 95886, it is important to remember that it is an add-on code and should be used in conjunction with an appropriate primary code for nerve conduction studies (codes 95905 to 95913). The code can be reported once for each extremity tested, up to four times if all four extremities are tested. Do not separately report EMG testing of paraspinal muscles when performed as part of the extremity EMG diagnostic testing. Additionally, do not report CPT 95886 in conjunction with codes 95860-95864, 95870, 95905, 0766T, or 0768T.

8. Historical information

CPT 95886 was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates to the code since its addition.

9. Similar codes to CPT 95886

Five similar codes to CPT 95886 and how they differentiate from CPT 95886 are:

• CPT 95885: Limited needle electromyography, studying fewer muscles and nerves than CPT 95886.
• CPT 95860: Needle electromyography of one extremity, without mention of related paraspinal areas.
• CPT 95861: Needle electromyography of two extremities, without mention of related paraspinal areas.
• CPT 95863: Needle electromyography of three extremities, without mention of related paraspinal areas.
• CPT 95864: Needle electromyography of four extremities, without mention of related paraspinal areas.

10. Examples

Here are 10 detailed examples of CPT code 95886 procedures:

1. A patient with suspected carpal tunnel syndrome undergoes a complete needle electromyography of the right upper extremity, studying five muscles innervated by three nerves, along with a nerve conduction study.
2. A patient with a history of lumbar radiculopathy undergoes a complete needle electromyography of the left lower extremity, studying six muscles innervated by four nerves, in conjunction with a nerve conduction study.
3. A patient with suspected Guillain-Barré syndrome undergoes a complete needle electromyography of both upper extremities, studying five muscles in each extremity innervated by three nerves, along with nerve conduction studies.
4. A patient with a history of peripheral neuropathy undergoes a complete needle electromyography of the right lower extremity, studying seven muscles innervated by four nerves, in conjunction with a nerve conduction study.
5. A patient with suspected myopathy undergoes a complete needle electromyography of the left upper extremity, studying five muscles innervated by three nerves, along with a nerve conduction study.
6. A patient with a history of cervical radiculopathy undergoes a complete needle electromyography of the right upper extremity, studying six muscles innervated by four nerves, in conjunction with a nerve conduction study.
7. A patient with suspected motor neuron disease undergoes a complete needle electromyography of both lower extremities, studying five muscles in each extremity innervated by three nerves, along with nerve conduction studies.
8. A patient with a history of brachial plexopathy undergoes a complete needle electromyography of the left upper extremity, studying seven muscles innervated by four nerves, in conjunction with a nerve conduction study.
9. A patient with suspected polyneuropathy undergoes a complete needle electromyography of the right lower extremity, studying five muscles innervated by three nerves, along with a nerve conduction study.
10. A patient with a history of sciatic nerve injury undergoes a complete needle electromyography of the left lower extremity, studying six muscles innervated by four nerves, in conjunction with a nerve conduction study.