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Needle electromyography (EMG) is a specialized diagnostic procedure utilized to assess and evaluate various neuromuscular conditions that may manifest as pain, weakness, numbness, or tingling sensations in the upper or lower extremities. This test is instrumental in recording the electrical activity of muscles, which can reveal abnormalities indicative of underlying medical issues. Such abnormalities in electrical activity may arise from a range of diseases or conditions, including but not limited to muscle inflammation, nerve compression, intervertebral disc herniation, peripheral nerve injuries, muscular dystrophy, amyotrophic lateral sclerosis (ALS), and myasthenia gravis. During the procedure, one or more fine needle electrodes are carefully inserted through the skin and into the muscle tissue. These electrodes are connected to a recording device that visually displays the electrical activity being monitored. To obtain comprehensive data, the patient may be instructed to move the affected extremity, allowing for the collection of electrical recordings during both muscle contraction and relaxation phases. The response of muscle fibers to nerve stimulation, known as action potential, is graphically represented as a waveform on the display. This procedure also encompasses any EMG recordings from associated paraspinal areas, providing a broader context for the physician's evaluation. Following the test, the physician meticulously reviews the EMG recordings and compiles a detailed written report summarizing the findings. For coding purposes, the appropriate CPT® code for needle EMG of one extremity is 95860, while codes 95861, 95863, and 95864 correspond to needle EMG of two, three, and four extremities, respectively.
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Needle electromyography (EMG) is indicated for the evaluation of various symptoms and conditions that may affect the neuromuscular system. The following are the explicitly provided indications for performing this procedure:
The needle electromyography procedure involves several key steps to ensure accurate assessment of muscle and nerve function. The following procedural steps are outlined:
Post-procedure care for needle electromyography typically involves monitoring the patient for any immediate adverse reactions, such as discomfort or bruising at the electrode insertion sites. Patients may be advised to rest the affected extremity for a short period following the procedure. The physician will discuss the results of the EMG with the patient during a follow-up appointment, providing insights into the findings and potential next steps for treatment or further evaluation if necessary. It is important for patients to report any unusual symptoms or prolonged discomfort following the procedure to their healthcare provider.
| Short Descr | NEEDLE EMG 1 EXTREMITY | Medium Descr | NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS | Long Descr | Needle electromyography; 1 extremity with or without related paraspinal areas | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 1 - Diagnostic Tests for Radiology Services | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | STV-Packaged Codes | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 7 - Other diagnostic nervous system procedures |
This is a primary code that can be used with these additional add-on codes.
| 95940 | Addon Code Resequenced Code MPFS Status: Active Code APC N Continuous intraoperative neurophysiology monitoring in the operating room, one on one monitoring requiring personal attendance, each 15 minutes (List separately in addition to code for primary procedure) | 95941 | Addon Code Resequenced Code MPFS Status: Not valid for Medicare purposes APC N Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby) or for monitoring of more than one case while in the operating room, per hour (List separately in addition to code for primary procedure) | G0453 | Add-on Code Medicare Coverage: Carrier Priced MPFS Status: Active Code APC N Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure) |
| 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | RT | Right side (used to identify procedures performed on the right side of the body) | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | GA | Waiver of liability statement issued as required by payer policy, individual case | GC | This service has been performed in part by a resident under the direction of a teaching physician | GP | Services delivered under an outpatient physical therapy plan of care | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | KX | Requirements specified in the medical policy have been met | LT | Left side (used to identify procedures performed on the left side of the body) | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2025-01-01 | Changed | Short Description changed. |
| 2011-01-01 | Changed | Short description changed. |
| 2010-01-01 | Changed | Code description changed. |
| 2003-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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