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Needle electromyography (EMG) is a diagnostic procedure used to assess the electrical activity of muscles and the function of the nerves that control them. Specifically, CPT® Code 95869 pertains to the evaluation of the thoracic paraspinal muscles, which are located alongside the spine in the thoracic region. This procedure excludes the assessment of the muscles at the T1 and T12 vertebral levels. During the EMG, a physician palpates the area of the thoracic spine where the patient is experiencing pain or other symptoms related to nerve or muscle dysfunction. An EMG electrode needle is then carefully inserted through the skin into the paravertebral gutter, which is the space adjacent to the vertebrae, and positioned within the targeted thoracic paravertebral muscles. The electrical activity of these muscles is recorded, allowing the physician to evaluate their function. Following the procedure, the physician analyzes the EMG recordings and compiles a written report detailing the findings, which can assist in diagnosing various neuromuscular conditions or injuries affecting the thoracic spine region.
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The needle electromyography procedure, as described by CPT® Code 95869, is indicated for the evaluation of muscle and nerve function specifically in the thoracic paraspinal muscles. This procedure is typically performed in patients presenting with symptoms such as:
The procedure for needle electromyography of the thoracic paraspinal muscles involves several key steps, which are outlined as follows:
Following the needle electromyography procedure, patients may experience mild discomfort or soreness at the needle insertion sites, which typically resolves quickly. The physician may provide specific post-procedure care instructions, including recommendations for activity levels and any necessary follow-up appointments to discuss the EMG findings. It is important for patients to monitor for any unusual symptoms, such as increased pain or swelling, and to report these to their healthcare provider. The written report generated from the EMG will be used to guide further diagnostic or therapeutic interventions based on the findings.
| Short Descr | NDL EMG THRC PARASPINAL MUSC | Medium Descr | NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12 | Long Descr | Needle electromyography; thoracic paraspinal muscles (excluding T1 or T12) | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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) | RT | Right side (used to identify procedures performed on the right side of the body) | 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 | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 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. |
| 2003-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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