2025 CPT code 95870
(Active) Effective Date: N/A Revision Date: N/A Neurology - Electromyography Medicine Services and Procedures > Neurology and Neuromuscular Procedures Feed
Needle electromyography (EMG) of limited muscles (four or fewer) in one extremity or non-limb muscles (unilateral or bilateral), excluding specific areas.
Modifiers 26 (professional component only) and TC (technical component only) may be appended as appropriate, depending on the services rendered.
Medical necessity for 95870 is established when there is a clinical indication suggesting neuromuscular pathology requiring investigation through EMG. This includes symptoms like muscle weakness, pain, atrophy, or abnormal reflexes that cannot be fully explained by other means.Documentation must support the clinical need for the test.
The physician or qualified healthcare professional is responsible for performing the needle EMG procedure, interpreting the results, and generating a report. This includes inserting the needle electrodes, recording and analyzing the electrical signals, and providing a diagnosis based on findings.
- Medicine Services and Procedures > Neurology and Neuromuscular Procedures
- Neurology and Neuromuscular Procedures
In simple words: This test checks the electrical activity of muscles using tiny needles inserted into the muscles. It's used to diagnose muscle and nerve problems, but it only examines a few muscles in one arm or leg, or a few muscles in the body's center, not the back muscles, face muscles, or muscles controlling bladder or bowel function.
This CPT code, 95870, represents a needle electromyography (EMG) procedure involving a limited study of muscles.The study is restricted to a maximum of four muscles within a single extremity or in non-limb (axial) muscles, performed either unilaterally or bilaterally.Importantly, this code excludes studies of thoracic paraspinal muscles, muscles innervated by cranial nerves, and sphincter muscles. The procedure involves inserting needle electrodes into the selected muscles to record and analyze their electrical activity, providing diagnostic information about neuromuscular function.
Example 1: A patient presents with weakness in the right forearm.The physician performs a limited EMG study of three muscles in the forearm using code 95870 to evaluate for possible nerve compression or muscle pathology., A patient reports pain in the left shoulder and neck. The physician uses code 95870 to conduct a limited EMG assessment of two muscles in the neck and one in the shoulder to determine the cause of the pain (e.g., muscle strain, radiculopathy)., A patient experiences unexplained lower back pain. A limited EMG evaluation of three muscles in the lower back is performed using 95870 to differentiate between muscle issues and nerve root involvement.
* Detailed patient history, including symptoms, onset, and duration.* Complete neurological examination findings.* Specific muscles studied during the EMG.* Detailed interpretation of the EMG waveforms and findings.* Diagnostic impression and recommendations.
** Always verify the specific muscles tested against the CPT code description to ensure accurate coding.If a more extensive EMG study is performed, use a more appropriate code.
- Revenue Code: P6C (Medicare Fee Schedule: MINOR PROCEDURES - OTHER)
- RVU: RVUs vary based on geographic location and payer. Consult the appropriate fee schedule for specific values.
- Global Days: Not applicable.This code does not typically encompass a global surgical period.
- Payment Status: Active
- Modifier TC rule: Modifier TC (Technical Component) may be appended when only the technical aspect of the procedure is performed by the billing entity.
- Fee Schedule: Historical fee schedules vary significantly depending on payer, location, and year.Consult relevant fee schedules for specific historical data.
- Specialties:Neurology, Physical Medicine and Rehabilitation, Neurosurgery
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center