When performing intraoperative monitoring for a pedicle screw surgery, how would I report stimulating the screw and checking for a motor nerve response?
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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