Neurology & Pain Management Coding Alert

Question: Notes indicate that the provider performed a short-latency somatosensory evoked potential study in the patient’s left arm. How should I report this encounter?

New Hampshire Subscriber

Answer: You should probably check with the payer on this one. The code for upper limb short-latency somatosensory evoked potential study is 95925 (Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs). As the descriptor indicates, the code covers the study of both limbs.

Your encounter involved a unilateral study, so you should reflect that in your coding. Again, you should check with your payer, but they’ll likely recommend that you report:

• 95925 for the evoked potential study
• Modifier 52 (Reduced services) appended to 95925 to show that you are only coding for study of one — not both — upper limbs.

One more maybe: The payer might also want you to append modifier LT (Left side) to 95925 to indicate laterality. This is completely arbitrary and will vary by payer; some will want LT submitted along with 52, while others could tell you that the encounter notes and modifier 52 are enough to garner payment for a unilateral 95925.