Wiki Pedicle screw testing

moaks

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During intraoperative monitoring of spinal surgery, the technician will test the pedicle screws the surgeon inserts with a triggered EMG to assure that no nerves are damaged. The Director of Technical Operations is telling me that they are doing a nerve conduction study. I do not see how this is a study as the outcomes are not documented as such. According to the code description, a triggered EMG is still an EMG. They are already doing a free running EMG during the procedure, so no other codes can be applied... is this correct?
 
You are correct. The monitoring should not be reported as nerve conduction studies. The following is from the May 2013 CPT Assistant:
"Use electromyography codes 95860-95864, 95869, 95870, 95885, or 95886 when performing monitoring during pedicle screw placement. "

and June 2005 CPT Assistant (monitoring codes included in answer are before updates:
Q: When performing intraoperative monitoring for a pedicle screw surgery, how would I report stimulating the screw and checking for a motor nerve response?

A: CPT code 95920, Intraoperative neurophysiology testing, per hour (List separately in addition to code for primary procedure), should be reported for every hour spent monitoring in the operating room once the baseline test is completed. For pedicle screw stimulation, the individual performing the intraoperative electrophysiologic monitoring is usually evaluating free-run and triggered electromyography (the triggered electromyography is when the pedicle screw is stimulated). CPT code 95870, Needle electromyography; limited study of muscles in one extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters, should be reported for free-run and triggered electromyography testing in addition to one unit of 95920 for each hour of monitoring performed. Two units of 95870 may be reported if stimulating each leg. If five or more muscles have been stimulated, then it would be appropriate to report code 95861, Needle electromyography, two extremities with or without related paraspinal areas.
 
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