2025 CPT code 95868
(Active) Effective Date: N/A Revision Date: N/A Neurology - Electromyography Medicine Services and Procedures > Neurology and Neuromuscular Procedures Feed
Needle electromyography of cranial nerve-supplied muscles, unilateral.
Modifiers 26 (professional component) and TC (technical component) may be applicable depending on the circumstances of the service delivery.
The medical necessity for a unilateral needle EMG of cranial nerve-supplied muscles is typically established by the presence of symptoms suggesting dysfunction of these nerves or the muscles they innervate, warranting further electrodiagnostic testing to determine the underlying cause.The specifics depend on the payer and their medical policies.
The neurologist or qualified healthcare professional is responsible for performing the needle EMG, interpreting the results, and generating a report.
- Medicine Services and Procedures > Neurology and Neuromuscular Procedures
- Neurology and Neuromuscular Procedures
In simple words: The doctor inserts a small needle into a muscle on one side of the body to check its electrical activity. This helps determine if the muscle and the nerve that controls it are working correctly. The test uses a computer to show the muscle’s activity and a speaker to make sounds.
This CPT code 95868 represents a unilateral needle electromyography (EMG) of muscles innervated by cranial nerves.The procedure involves inserting a needle electrode into the muscle(s) to record electrical activity during rest and contraction.The signals are processed by a computer and loudspeaker to create waveforms and audible sounds for interpretation and analysis.This code is used when the nerve conduction study is not performed on the same day.
Example 1: A patient presents with weakness in facial muscles.A unilateral needle EMG of cranial nerve-supplied muscles is performed to assess for myopathy or neuropathy., A patient complains of unilateral tongue weakness.A unilateral needle EMG is conducted to evaluate the function of the hypoglossal nerve., A patient presents with difficulty swallowing.Unilateral needle EMG of muscles involved in swallowing is performed to identify the cause of dysphagia.
** Always verify the code's appropriateness and applicability with the specific payer's guidelines and local policies.Miscoding can lead to claim denials or payment delays.
- Revenue Code: P6C (Medicare Fee Schedule: Minor Procedures - Other)
- RVU: The RVUs for this code will vary depending on several factors, including geographic location and payer. Consult the appropriate fee schedule for specific values.
- Global Days: The global period for this procedure is typically not specified and depends on the overall clinical context and payer policy.
- Payment Status: Active
- Modifier TC rule: Modifier TC may be used if only the technical component of the service was performed.
- Fee Schedule: Fee schedules are dynamic and vary by location and payer.Consult relevant fee schedules for historical data.
- Specialties:Neurology, neuromuscular medicine
- Place of Service:Office, hospital outpatient department, ambulatory surgical center