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2025 CPT code 95867

Needle electromyography of cranial nerve-supplied muscles, unilateral.

Adhere to all relevant CPT coding guidelines for neurology and neuromuscular procedures.Specific instructions related to unilateral versus bilateral studies and the inclusion of nerve conduction studies are crucial for accurate coding.

Modifier 26 (professional component) may be appended if only the professional interpretation component is billed.Modifier TC (technical component) may be appended if only the technical component is billed, depending on who provided the technical component. See Modifier section for details.

Medical necessity for 95867 is established when clinical findings warrant a detailed assessment of neuromuscular function in muscles supplied by cranial nerves. This would typically include symptoms of weakness, muscle atrophy, pain, or other neurological deficits affecting the specific cranial nerve innervation. The ordering physician's documentation must support the clinical suspicion requiring this test.

The clinical responsibility lies with a physician or other qualified healthcare professional who performs the EMG procedure, interprets the results, and provides a report. This includes proper preparation of the patient, insertion of the needle electrode, recording of electrical activity, and interpretation of the waveforms to identify any abnormalities.

IMPORTANT:Use 95868 for bilateral needle electromyography.Do not report codes 95860-95875 in addition to 96000-96004. For EMG services performed with nerve conduction studies, refer to 95885-95887.For needle electromyography of other specific sites (anal/urethral sphincter, larynx, hemidiaphragm, extra-ocular muscles), use the appropriate alternative codes as detailed in the CPT guidelines.

In simple words: The doctor inserts a tiny needle into a muscle in your head or neck to check its electrical activity. This helps them see if the muscle and nerve connecting to it are working correctly.The test is done on one side of the body only, and it doesn't include other tests that day.

This CPT code encompasses the procedure of needle electromyography (EMG) performed on muscles innervated by cranial nerves on one side of the body.The procedure involves inserting a needle electrode into the target muscle(s) to record electrical activity during rest and contraction.The recorded electrical signals are then interpreted by a qualified healthcare professional to assess neuromuscular function. This is a unilateral study, meaning it's conducted on only one side of the body.Note that nerve conduction studies are not performed on the same day.

Example 1: A patient presents with symptoms suggestive of a cranial nerve VII palsy (Bell's palsy).95867 would be used to assess the electrical activity of the affected facial muscles unilaterally., A patient experiences weakness in the muscles of mastication (chewing) potentially indicating a trigeminal nerve (V) pathology. 95867 could be used for the unilateral evaluation of the relevant muscles., A patient exhibits swallowing difficulties and voice changes potentially related to cranial nerves IX, X, or XI dysfunction.95867 could be used to evaluate the relevant unilateral muscle groups (e.g., pharyngeal muscles).

** Always refer to the most current CPT manual and payer-specific guidelines for the most accurate and up-to-date coding information.This information is current as of December 3, 2024, and is subject to change.

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