2025 CPT code 95863
Effective Date: N/A Revision Date: N/A Medicine - Neurology and Neuromuscular Procedures Feed
Needle electromyography of three extremities with or without related paraspinal areas.
Modifiers can be applied to 95863 as appropriate. For example, modifier 26 is used for professional component only, 52 for reduced services, and 59 for distinct procedural service.
Medical necessity must be established for this procedure. Documentation should support the diagnosis of a neuromuscular disorder requiring EMG testing, correlation of symptoms with the tested extremities, and how the results will influence treatment decisions.
The physician performing the procedure is responsible for needle insertion, monitoring electrical activity, interpretation of the results, and report generation.
In simple words: This procedure uses tiny needles to measure the electrical activity of muscles in three of your limbs (arms or legs). It helps doctors figure out if there are problems with your nerves or muscles. The doctor might also check muscles next to your spine.
Needle electromyography (EMG) involves inserting a needle electrode into muscles to record their electrical activity at rest and during contraction. This procedure helps diagnose neuromuscular disorders. Code 95863 specifically refers to performing needle EMG on three extremities and may also include related paraspinal areas (excluding T3-T11). The procedure involves evaluating extremity muscles innervated by three nerves (e.g., radial, ulnar, median) or four spinal levels, with a minimum of five muscles studied per limb.
Example 1: A patient presents with weakness and numbness in both arms and one leg. 95863 is used for needle EMG testing of all three affected extremities to assess nerve and muscle function., A patient with suspected cervical radiculopathy undergoes needle EMG of both arms and one leg to determine the extent and location of nerve compression. 95863 is reported, including paraspinal areas in the neck., A patient experiences pain and tingling in the lower back, radiating down one leg. 95863 covers EMG testing of both legs and one arm if symptoms suggest involvement of other nerves or to establish a baseline.
Documentation should include the medical necessity for the procedure, patient symptoms, the extremities tested, the nerves examined, the number of muscles studied per extremity, findings, and interpretation.
- Modifier TC rule: Modifier TC can be applied when reporting the technical component of the procedure, if applicable.
- Specialties:Physical Medicine and Rehabilitation, Neurology, Neurosurgery
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital (if medically necessary)