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Official Description

Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and R-R interval changes during Valsalva maneuver and at least 5 minutes of passive tilt

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The autonomic nervous system (ANS) is a critical component of the human body, responsible for regulating involuntary physiological functions, including heart rate, blood pressure, and digestion. It is divided into two main branches: the sympathetic nervous system, which prepares the body for 'fight or flight' responses, and the parasympathetic nervous system, which promotes 'rest and digest' activities. CPT® Code 95922 specifically pertains to the testing of sympathetic adrenergic function, which is essential for understanding how the body responds to stressors and maintains homeostasis. This procedure evaluates the vasomotor adrenergic innervation, focusing on the body's ability to regulate blood pressure and heart rate in response to specific maneuvers. During the testing, an electrocardiographic (ECG) rhythm strip is utilized to monitor heart rate and R-R intervals, which are critical for assessing the timing between heartbeats. The Valsalva maneuver, a technique that involves forcefully exhaling with the glottis closed, is employed to create changes in intrathoracic pressure, thereby affecting venous return and blood pressure. Additionally, a passive tilt test is conducted, where the patient is positioned on a tilt table to observe the body's response to changes in posture. This comprehensive assessment helps identify any dysfunction in the sympathetic nervous system, which can have significant implications for cardiovascular health and overall autonomic regulation.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The testing of autonomic nervous system function using CPT® Code 95922 is indicated for various clinical scenarios where assessment of sympathetic adrenergic function is necessary. The following conditions may warrant this procedure:

  • Orthostatic Hypotension - A condition characterized by a significant drop in blood pressure upon standing, leading to dizziness or fainting.
  • Syncope - Episodes of transient loss of consciousness, which may be related to autonomic dysfunction.
  • Autonomic Neuropathy - Often seen in patients with diabetes or other systemic diseases, where the autonomic nervous system is compromised.
  • Cardiovascular Disorders - Conditions that may affect blood pressure regulation and heart rate, necessitating evaluation of autonomic function.
  • Evaluation of Vasovagal Responses - Situations where abnormal responses to stress or postural changes are suspected.

2. Procedure

The procedure for testing autonomic nervous system function under CPT® Code 95922 involves several key steps to accurately assess sympathetic adrenergic function:

  • Step 1: Preparation - The patient is prepared for the test by ensuring they are in a comfortable position, typically lying down, and are informed about the procedure. An ECG rhythm strip is attached to monitor heart rate and R-R intervals throughout the testing process.
  • Step 2: Valsalva Maneuver - The patient is instructed to perform the Valsalva maneuver, which involves forcefully exhaling against a closed glottis. This action increases intrathoracic pressure and reduces venous return to the heart. During this maneuver, beat-to-beat blood pressure and R-R intervals are recorded to observe the physiological responses and reflex vasoconstriction, which should occur if sympathetic function is normal.
  • Step 3: Passive Tilt Test - Following the Valsalva maneuver, the patient is placed on a tilt table initially in a head-down position for at least five minutes. This position allows for stabilization of blood pressure and heart rate. The tilt table is then moved to a head-up position, which causes blood to shift from the head to the extremities. The body's response to this change is monitored, and any reflex adjustments in blood pressure are recorded, indicating the functionality of the sympathetic nervous system.

3. Post-Procedure

After the completion of the tests, the patient is typically monitored for a short period to ensure stability in heart rate and blood pressure. The physician will review the recorded data, including the ECG rhythm strip and blood pressure readings, to analyze the results. A written report detailing the findings of the tests is generated, which may include interpretations of the sympathetic adrenergic function based on the responses observed during the Valsalva maneuver and tilt test. Patients may be advised on any necessary follow-up actions or further evaluations based on the results of the testing.

Short Descr AUTONOMIC NRV ADRENRG INERVJ
Medium Descr TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ
Long Descr Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and R-R interval changes during Valsalva maneuver and at least 5 minutes of passive tilt
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) 1 - Medical Care
Berenson-Eggers TOS (BETOS) T2D - Other tests - other
MUE 1
CCS Clinical Classification 7 - Other diagnostic nervous system procedures
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.
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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.
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
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
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).
GA Waiver of liability statement issued as required by payer policy, individual case
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
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)
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
Date
Action
Notes
2013-01-01 Changed Short Descriptor changed. Guidelines added.
2009-01-01 Changed Code description changed
1997-01-01 Added First appearance in code book in 1997.
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