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Neurology & Pain Management Coding Alert

Reader Question:

5178x Could Apply to Transcranial Motor Evoked Potentials Test

Published on Wed Sep 14, 2011

Question: We don't know the best way to report transcranial motor evoked potentials for external anal and urethral sphincter muscle monitoring. The AAN's "Principles of Coding for Intraoperative Neurophysiologic Monitoring (IOM) and Testing" recommends 95870, but that's an EMG code and I'm not sure it applies to sphincter muscles.　Does CPT® have a better code that we missed? Nebraska Subscriber Answer: CPT® does not have a specific code for transcranial motor evoked potential testing of the sphincter muscles. You're also correct that code 95870 (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) might not be the best choice, because the descriptor states to not report 95870 for needle EMG of sphincter muscles. Option: Check with the neurologist to learn whether she performed EMG testing of the anal/urethral sphincter muscles (the baseline intraoperative study [...]
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