2025 CPT code 95861
(Active) Effective Date: N/A Revision Date: N/A Medicine - Neurology and Neuromuscular Procedures Feed
Needle electromyography (EMG) of two extremities with or without related paraspinal areas.
Modifiers may be applicable to 95861. Modifier 26 is used if only the professional component (interpretation and report) is performed. Modifier 59 may be used to indicate a distinct procedural service if appropriate.
Medical necessity for 95861 must be established by documenting the patient's symptoms and signs, which suggest a neuromuscular disorder affecting two extremities. Examples may be weakness, numbness, pain, or tingling in two limbs.
The physician performing the EMG is responsible for the entire procedure, including needle insertion, recording of electrical activity, interpretation of the results, and report generation. The physician must select the appropriate code based on the number of extremities and paraspinal areas examined.
In simple words: This test measures the electrical activity in your muscles. The doctor inserts tiny needles into the muscles of two of your arms or legs to record the electrical signals. This helps diagnose conditions like nerve or muscle damage.
This code represents a needle electromyography (EMG) study performed on two extremities. It involves inserting needle electrodes into the muscles of two extremities to record electrical activity during rest and contraction. The procedure may also include assessment of related paraspinal areas, except for the thoracic region (T3-T11). The recording, interpretation, and report are included in the service.
Example 1: A patient presents with weakness and numbness in both legs. An EMG of both lower extremities (95861) is performed to evaluate for peripheral neuropathy., A patient has pain and tingling in the right arm and leg. 95861 is used as two extremities are involved, helping determine if a nerve root compression is the source of the pain., A patient experiences muscle weakness in the left arm and leg following a stroke. Code 95861 is reported since the assessment involves two extremities and aids in evaluating the extent of neurological damage.
Documentation should include the medical reason for the EMG, the specific muscles tested in each extremity, the findings of the EMG study, and the interpretation of the results. If related paraspinal areas are examined, they should also be documented.
- Modifier TC rule: Modifier TC is used if only the technical component of the procedure is provided.
- Specialties:Neurology, Physiatry, Physical Medicine and Rehabilitation
- Place of Service:Office, Outpatient Hospital, Independent Clinic