Neurology & Pain Management Coding Alert

Question: Our neurologist is being asked to provide intraoperative monitoring (IOM) for two surgical patients simultaneously. Is this allowable, and if so, can we report both cases?


Wisconsin Subscriber


Answer: The answer to your question will depend entirely on the payers you-re dealing with.

Medicare does have a national coverage determination (NCD) that allows you to report remote IOM as long as the physician is using -online real-time monitoring---meaning the neurologist must have a real-time connection with a technician in the operating room and immediate access to the surgeon. But the NCD stops short of any decision on multiple cases for +95920 (Intraoperative neurophysiology testing, per hour [list separately in addition to code for primary procedure]).

Some carriers offer more specific guidelines for IOM. For example, Wisconsin Physician Services will allow a neurologist to monitor more than one patient simultaneously, as long as this is the only service that he is providing at the time.