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Otolaryngology Coding Alert

Reader Question:

Facial Nerve Monitoring

Published on Thu Dec 27, 2012

Question: The otolaryngologist resects a facial neuroma. Nerve monitoring is performed during the surgery to avoid facial nerve damage. How should we bill for this service?

Minnesota Subscriber
Answer: Facial nerves may be monitored intraoperatively to enhance the preservation of facial nerves during some extensive surgery, such as acoustic neuroma resection and cochlear implantation.
 
CPT 95920 (intraoperative neurophysiology testing, per hour [list separately in addition to code for primary procedure]) may be used to report facial nerve monitoring. CPT also tells physicians, however, that this add-on code should be billed only when monitoring is performed with the following studies:
  92585 auditory evoked potentials for evoked response audiometry and/or testing of the central nervous system; comprehensive

95822 electroencephalogram (EEG); sleep only

95860 needle electromyography, one extremity with or without related paraspinal areas
  95861 [...]
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