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Electrodiagnostic studies of the blink reflex, also known as the orbicularis oculi reflex, are specialized tests conducted to assess the functionality of the trigeminal cranial nerve (CN V), the facial nerve (CN VII), and the brainstem. This procedure is essential for diagnosing and localizing potential pathologies affecting these neural structures. The blink reflex is a protective mechanism that involves a neural circuit starting from the cornea, where sensory nerve endings are located. When the cornea is stimulated, a nerve impulse is generated and travels through the trigeminal nerve and its ganglion, reaching the spinal trigeminal tract and nucleus. From there, the signal is relayed to interneurons in the reticular formation, which then activate motor neurons in the facial nucleus and nerve, ultimately resulting in a contraction of the orbicularis oculi muscles that causes a blink. During the electrodiagnostic testing, a brief electrical stimulus is applied, typically to the supraorbital nerve, to provoke a blink response. Electrodes are strategically placed on the skin surrounding the eyes to capture the responses elicited by the electrical stimulation. The supraorbital nerve is stimulated using an electrode positioned above each eyebrow, and the resulting responses are recorded and displayed on a computer screen. These recordings are subsequently printed and analyzed by a physician, who provides a comprehensive written interpretation of the test results, aiding in the diagnosis of any underlying conditions affecting the cranial nerves or brainstem.
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Electrodiagnostic studies of the blink reflex are indicated for the following conditions:
The procedure for conducting electrodiagnostic studies of the blink reflex involves several key steps:
After the electrodiagnostic study of the blink reflex is completed, the patient may resume normal activities immediately, as there are typically no significant side effects associated with the procedure. The physician will discuss the findings with the patient during a follow-up appointment, where the results will be interpreted in the context of the patient's clinical history and symptoms. Any necessary further diagnostic testing or treatment options may be recommended based on the outcomes of the blink reflex study.
| Short Descr | BLINK REFLEX TEST | Medium Descr | ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST | Long Descr | Orbicularis oculi (blink) reflex, by electrodiagnostic testing | 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) | T2D - Other tests - other | 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) |
| 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. | 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. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 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 | GZ | Item or service expected to be denied as not reasonable and necessary | LT | Left side (used to identify procedures performed on the left side of the body) | 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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| 2011-01-01 | Changed | Medium description changed. |
| Pre-1990 | Added | Code added. |
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