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Continuous intraoperative neurophysiology monitoring is a critical procedure performed during surgical operations to ensure the safety and integrity of the nervous system. This monitoring involves the ongoing assessment of electrophysiological signals, specifically sensory evoked potentials and electromyography (EMG) potentials, throughout the duration of the surgical procedure. The primary goal of this monitoring is to detect any potential neurological deficits that may arise during surgery, thereby minimizing the risk of permanent postoperative complications. The CPT® Code 95940 is specifically designated for instances where one-on-one monitoring is conducted, requiring the personal attendance of a qualified neurophysiologist or technician. This code is billed for each 15-minute interval of monitoring, and it is important to note that it should be reported separately in addition to the code for the primary surgical procedure being performed. This ensures that the additional resources and expertise required for continuous monitoring are appropriately recognized and reimbursed. In contrast, for cases involving multiple patients or procedures being monitored simultaneously, CPT® Code 95941 is utilized, which accounts for continuous monitoring on an hourly basis. Understanding the nuances of these codes is essential for accurate billing and compliance in the context of intraoperative neurophysiology monitoring.
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Continuous intraoperative neurophysiology monitoring is indicated in various surgical scenarios where there is a risk of neurological compromise. The following conditions and situations warrant the use of this monitoring technique:
The procedure for continuous intraoperative neurophysiology monitoring involves several key steps to ensure effective monitoring of the patient's neurological status during surgery. Each step is crucial for the accurate assessment of neural function:
After the surgical procedure is completed, the continuous intraoperative neurophysiology monitoring concludes. The neurophysiologist will review the collected data and provide a comprehensive report detailing the findings and any interventions that were necessary during the surgery. This report is essential for the surgical team's understanding of the patient's neurological status post-operation. Additionally, the patient may require follow-up assessments to evaluate their neurological function and recovery, ensuring that any potential deficits are addressed promptly. Proper documentation and communication of the monitoring results are vital for ongoing patient care and for any necessary claims processing related to the monitoring services provided.
| Short Descr | IONM IN OPERATNG ROOM 15 MIN | Medium Descr | IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES | Long Descr | 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) | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | 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 | 03 - Procedure must be performed under the personal supervision of physician. | 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 | Items and Services Packaged into APC Rates | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | T2D - Other tests - other | MUE | 32 | CCS Clinical Classification | 7 - Other diagnostic nervous system procedures |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 92653 | Resequenced Code MPFS Status: Active Code APC S Auditory evoked potentials; neurodiagnostic, with interpretation and report | 95822 | MPFS Status: Active Code APC S PUB 100 Electroencephalogram (EEG); recording in coma or sleep only | 95860 | MPFS Status: Active Code APC Q1 CPT Assistant Article Needle electromyography; 1 extremity with or without related paraspinal areas | 95861 | MPFS Status: Active Code APC Q1 CPT Assistant Article Needle electromyography; 2 extremities with or without related paraspinal areas | 95863 | MPFS Status: Active Code APC S CPT Assistant Article Needle electromyography; 3 extremities with or without related paraspinal areas | 95864 | MPFS Status: Active Code APC S CPT Assistant Article Needle electromyography; 4 extremities with or without related paraspinal areas | 95865 | MPFS Status: Active Code APC Q1 CPT Assistant Article Needle electromyography; larynx | 95866 | MPFS Status: Active Code APC Q1 CPT Assistant Article Needle electromyography; hemidiaphragm | 95867 | MPFS Status: Active Code APC S CPT Assistant Article Needle electromyography; cranial nerve supplied muscle(s), unilateral | 95868 | MPFS Status: Active Code APC S CPT Assistant Article Needle electromyography; cranial nerve supplied muscles, bilateral | 95869 | MPFS Status: Active Code APC Q1 CPT Assistant Article Needle electromyography; thoracic paraspinal muscles (excluding T1 or T12) | 95870 | MPFS Status: Active Code APC Q1 CPT Assistant Article Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters | 95907 | MPFS Status: Active Code APC S Nerve conduction studies; 1-2 studies | 95908 | MPFS Status: Active Code APC S Nerve conduction studies; 3-4 studies | 95909 | MPFS Status: Active Code APC S Nerve conduction studies; 5-6 studies | 95910 | MPFS Status: Active Code APC S Nerve conduction studies; 7-8 studies | 95911 | MPFS Status: Active Code APC S Nerve conduction studies; 9-10 studies | 95912 | MPFS Status: Active Code APC S Nerve conduction studies; 11-12 studies | 95913 | MPFS Status: Active Code APC S Nerve conduction studies; 13 or more studies | 95925 | MPFS Status: Active Code APC S PUB 100 CPT Assistant Article Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs | 95926 | MPFS Status: Active Code APC S PUB 100 CPT Assistant Article Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs | 95927 | MPFS Status: Active Code APC S PUB 100 CPT Assistant Article Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head | 95928 | MPFS Status: Active Code APC S PUB 100 Central motor evoked potential study (transcranial motor stimulation); upper limbs | 95929 | MPFS Status: Active Code APC S PUB 100 Central motor evoked potential study (transcranial motor stimulation); lower limbs | 95930 | MPFS Status: Active Code APC S PUB 100 CPT Assistant Article Visual evoked potential (VEP) checkerboard or flash testing, central nervous system except glaucoma, with interpretation and report | 95933 | MPFS Status: Active Code APC Q1 PUB 100 CPT Assistant Article Orbicularis oculi (blink) reflex, by electrodiagnostic testing | 95937 | MPFS Status: Active Code APC S PUB 100 CPT Assistant Article Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method | 95938 | Resequenced Code MPFS Status: Active Code APC S Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs | 95939 | Resequenced Code MPFS Status: Active Code APC S Central motor evoked potential study (transcranial motor stimulation); in upper and lower limbs |
| 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 | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | GZ | Item or service expected to be denied as not reasonable and necessary | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | RT | Right side (used to identify procedures performed on the right side of the body) | 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). | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 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. | AT | Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942) | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left 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 |
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| 2021-01-01 | Note | Guidelines changed. |
| 2013-01-01 | Added | Added |
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