How To Use CPT Code 95926

CPT 95926 describes the procedure for a short-latency somatosensory evoked potential study in the lower limbs. 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 95926?

CPT 95926 is used to describe a short-latency somatosensory evoked potential study in the lower limbs. This procedure involves stimulating the peripheral nerves or skin sites in the lower limbs and recording the resulting evoked potential from the central nervous system. It helps evaluate the somatosensory function from the site of stimulation to the cerebral cortex, aiding in the diagnosis of peripheral nerve lesions, spinal cord issues, or brain abnormalities.

2. Official Description

The official description of CPT code 95926 is: ‘Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs.’

3. Procedure

  1. In this procedure, the provider applies brief electrical stimuli to the peripheral nerves or skin sites in the lower limbs.
  2. The provider selects either the posterior tibial nerve at the ankle or the common peroneal nerve at the knee for stimulation.
  3. Electrodes are placed over the spine and scalp to record the resulting evoked potential from the central nervous system.
  4. The recorded evoked potentials are processed by a computer and converted into waveforms.
  5. The provider analyzes these waveforms, which provide information about the stimulated nerve, recording sites, peak latencies, interpeak interval, and amplitude of significant components.
  6. This study helps evaluate the somatosensory function from the site of stimulation to the cerebral cortex, aiding in the diagnosis of peripheral nerve lesions, spinal cord issues, or brain abnormalities.

4. Qualifying circumstances

CPT 95926 is performed when there is a need to evaluate the somatosensory function in the lower limbs. It is used to assess patients with suspected peripheral nerve lesions, spinal cord issues, or brain abnormalities. The procedure is typically performed by a healthcare professional trained in conducting somatosensory evoked potential studies.

5. When to use CPT code 95926

CPT code 95926 should be used when a provider performs a short-latency somatosensory evoked potential study in the lower limbs. It is appropriate for evaluating the somatosensory function in patients with suspected peripheral nerve lesions, spinal cord issues, or brain abnormalities. This code should not be reported in conjunction with CPT code 95925, which is used for a similar study in the upper limbs.

6. Documentation requirements

To support a claim for CPT 95926, the provider must document the following information:

  • Patient’s symptoms or suspected condition warranting the somatosensory evoked potential study
  • Specific peripheral nerves or skin sites stimulated during the procedure
  • Date and duration of the study
  • Recorded evoked potentials and their analysis, including peak latencies, interpeak interval, and amplitude of significant components
  • Any additional relevant findings or observations
  • Provider’s signature

7. Billing guidelines

When billing for CPT 95926, ensure that the procedure is performed in the lower limbs and that the documentation supports the medical necessity of the study. It is important to follow the guidelines for reporting the professional and technical components of the service, using the appropriate modifiers if necessary. CPT code 95926 should not be reported in conjunction with CPT code 95925.

8. Historical information

CPT 95926 was added to the Current Procedural Terminology system on January 1, 1996. There have been no updates to the code since its addition.

9. Examples

  1. A neurologist performs a short-latency somatosensory evoked potential study in the lower limbs of a patient with suspected peripheral neuropathy.
  2. An orthopedic surgeon orders a somatosensory evoked potential study in the lower limbs to evaluate a patient with suspected spinal cord compression.
  3. A neurophysiologist conducts a short-latency somatosensory evoked potential study in the lower limbs of a patient with suspected brain abnormalities.
  4. A physical therapist assists in performing a somatosensory evoked potential study in the lower limbs of a patient recovering from a lower back injury.
  5. A neurosurgeon utilizes a short-latency somatosensory evoked potential study in the lower limbs to assess a patient before spinal surgery.
  6. A rehabilitation specialist conducts a somatosensory evoked potential study in the lower limbs of a patient with suspected nerve damage due to a traumatic injury.
  7. A neurology resident performs a short-latency somatosensory evoked potential study in the lower limbs of a patient with unexplained sensory symptoms.
  8. An electrodiagnostic technician assists in conducting a somatosensory evoked potential study in the lower limbs of a patient with suspected multiple sclerosis.
  9. A physiatrist orders a short-latency somatosensory evoked potential study in the lower limbs to evaluate a patient with suspected spinal cord injury.
  10. A neurology fellow performs a somatosensory evoked potential study in the lower limbs of a patient with suspected central nervous system abnormalities.

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