How To Use CPT Code 95970

CPT 95970 describes the electronic analysis of an implanted neurostimulator pulse generator/transmitter by a physician or other qualified healthcare professional. 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 95970?

CPT 95970 can be used to describe the electronic analysis of an implanted neurostimulator pulse generator/transmitter by a physician or other qualified healthcare professional. This code is used when the provider checks the programming and various parameters of the neurostimulator system to ensure its proper functioning. The analysis does not involve reprogramming the device.

2. Official Description

The official description of CPT code 95970 is: ‘Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [Hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop parameters, and passive parameters) by physician or other qualified health care professional; with brain, cranial nerve, spinal cord, peripheral nerve, or sacral nerve, neurostimulator pulse generator/transmitter, without programming.’

3. Procedure

1. A physician or other qualified healthcare professional performs electronic analysis of a previously implanted neurostimulator pulse generator/transmitter to ensure that it is functioning properly.
2. The provider checks various parameters of the neurostimulator system, including contact group(s), interleaving, amplitude, pulse width, frequency, on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop parameters, and passive parameters.
3. The analysis does not involve reprogramming the neurostimulator pulse generator/transmitter.

4. Qualifying circumstances

CPT 95970 is used for the electronic analysis of an implanted neurostimulator pulse generator/transmitter. This procedure is performed by a physician or other qualified healthcare professional. It is important to note that CPT 95970 should not be reported in conjunction with certain other codes, as specified in the notes.

5. When to use CPT code 95970

CPT code 95970 should be used when a physician or other qualified healthcare professional performs electronic analysis of an implanted neurostimulator pulse generator/transmitter without reprogramming. It is important to ensure that the analysis is performed on the brain, cranial nerve, spinal cord, peripheral nerve, or sacral nerve neurostimulator pulse generator/transmitter.

6. Documentation requirements

To support a claim for CPT 95970, the healthcare professional must document the following information:

• Patient’s diagnosis and the need for electronic analysis of the neurostimulator pulse generator/transmitter
• Specific parameters analyzed during the procedure, such as contact group(s), interleaving, amplitude, pulse width, frequency, on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop parameters, and passive parameters
• Date and duration of the analysis
• Results of the analysis and any necessary actions taken
• Signature of the physician or other qualified healthcare professional performing the analysis

7. Billing guidelines

When billing for CPT 95970, ensure that the analysis is performed by a physician or other qualified healthcare professional. It is important to follow the guidelines and not report CPT 95970 in conjunction with certain other codes, as specified in the notes. Pay attention to any additional tips or requirements provided by the payer or coding guidelines.

8. Historical information

CPT 95970 was added to the Current Procedural Terminology system on January 1, 1999. There have been historical changes to the code, including updates on January 1, 2012, and January 1, 2019. These changes reflect modifications to the description and parameters analyzed during the procedure.

9. Examples

1. A physician performing electronic analysis of an implanted neurostimulator pulse generator/transmitter in a patient with chronic pain.
2. A qualified healthcare professional checking the parameters of a neurostimulator system in a patient with Parkinson’s disease.
3. A physician analyzing the functioning of an implanted neurostimulator pulse generator/transmitter in a patient with epilepsy.
4. A neurologist performing electronic analysis of a neurostimulator pulse generator/transmitter in a patient with multiple sclerosis.