How To Use CPT Code 95909

CPT 95909 describes the performance of five or six nerve conduction studies, which are diagnostic tests used to evaluate the function and electrical conduction ability of motor and sensory nerves in the body. This article will provide an overview of CPT code 95909, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 95909?

CPT 95909 is used to describe the performance of five or six nerve conduction studies by a healthcare provider. These studies are diagnostic tests that assess the speed of electrical impulses through peripheral nerves, helping to identify the location of nerve damage or destruction. During the test, the provider places electrodes on the nerve being examined, stimulating it with a mild electrical impulse and recording the resulting electrical activity. This procedure is repeated for each nerve being tested, and the recorded data is analyzed to determine the conduction velocity, latency, and amplitude of the nerve.

2. Official Description

The official description of CPT code 95909 is: ‘Nerve conduction studies; 5-6 studies.’

3. Procedure

1. The healthcare provider prepares the patient for the nerve conduction study.
2. Electrodes are placed on the specific nerves to be tested.
3. The provider stimulates the nerves with a mild electrical impulse and records the resulting electrical activity.
4. This procedure is repeated for each nerve being tested, typically performing five or six studies.
5. The recorded data is analyzed to determine the conduction velocity, latency, and amplitude of the nerves.

4. Qualifying circumstances

CPT 95909 is performed when a patient requires five or six nerve conduction studies to evaluate the function and conduction ability of their motor and sensory nerves. This test is typically ordered when there is a suspected nerve damage or destruction. The provider must perform the studies and analyze the recorded data to determine the conduction velocity, latency, and amplitude of the nerves.

5. When to use CPT code 95909

CPT code 95909 should be used when a healthcare provider performs five or six nerve conduction studies for a patient. These studies are necessary to evaluate the function and electrical conduction ability of the patient’s motor and sensory nerves. It is important to accurately report the number of studies performed to ensure proper reimbursement.

6. Documentation requirements

To support a claim for CPT code 95909, the healthcare provider must document the following information:

• Reason for performing the nerve conduction studies
• Specific nerves tested
• Date of the procedure
• Results of the studies, including conduction velocity, latency, and amplitude
• Signature of the healthcare provider performing the studies

7. Billing guidelines

When billing for CPT code 95909, ensure that the provider performs five or six nerve conduction studies. If only the professional component is being reported, append modifier 26 to the code. If only the technical component is being reported, append modifier TC to the code, unless the technical component is provided by a hospital. In that case, do not append modifier TC. When reporting a global service where one provider renders both the professional and technical components, do not append any modifiers to the code.

8. Historical information

CPT code 95909 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates or changes to the code since its addition.

9. Examples

1. A neurologist performing five nerve conduction studies to evaluate a patient with suspected carpal tunnel syndrome.
2. An orthopedic surgeon conducting six nerve conduction studies to assess the function of a patient’s peripheral nerves after a traumatic injury.
3. A physiatrist performing five nerve conduction studies to evaluate a patient with suspected radiculopathy.
4. A neurologist conducting six nerve conduction studies to assess the function of a patient’s motor and sensory nerves in the lower extremities.
5. An electrophysiologist performing five nerve conduction studies to evaluate a patient with suspected peripheral neuropathy.
6. A physical therapist conducting six nerve conduction studies to assess the function of a patient’s nerves after a sports-related injury.
7. A neurologist performing five nerve conduction studies to evaluate a patient with suspected ulnar neuropathy.
8. An orthopedic surgeon conducting six nerve conduction studies to assess the function of a patient’s nerves after a surgical procedure.
9. A physiatrist performing five nerve conduction studies to evaluate a patient with suspected sciatica.
10. A neurologist conducting six nerve conduction studies to assess the function of a patient’s nerves in the upper extremities after a traumatic accident.