Neurology & Pain Management Coding Alert

Effective April 1, muscle testing codes 95831-95834 and range-of-motion measurement codes 95851-95852 are components of the E/M codes. The new Correct Coding Initiative (CCI) edits list the E/M codes as comprehensive, of which muscle testing and range of motion are components. These codes are listed with the identifying code of 0, which means modifier -59 (distinct procedural service) cannot be used to bill them separately.

For many practices, this may not be different from how insurers paid these claims in the past. Most Medicare carriers policies for these stated that testing and examination are integral parts of a musculoskeletal exam and are inclusive in the E/M. However, the CCI policy now makes the edits official.

Additionally, there have been changes to the new CPT 2001 codes for percutaneous vertebroplasty (22520 and 22521), which have been added to the comprehensive codes of which the corresponding CAT scan codes are now components. In other words, 22520 (percutaneous vertebroplasty, one vertebral body, unilateral or bilateral injection; thoracic) is the comprehensive, and CAT scan codes 72128 (computerized axial tomography, thoracic spine; without contrast material), 72129 (... with contrast material) and 72130 (... without contrast material, followed by contrast material[s] and further sections) are components. Also, 22521 (... lumbar) is the comprehensive, and CAT scan codes 72131 (computerized axial tomography, lumbar spine; without contrast material), 72132 (... with contrast material) and 72133 (... without contrast material, followed by contrast material[s] and further sections) are components.

These codes are listed with the identifying code of 1, which means modifier -59 (distinct procedural service) can be used to bill them separately.