2025 CPT code 95872
(Active) Effective Date: N/A Revision Date: N/A Neurology - Electromyography Medicine Services and Procedures > Neurology and Neuromuscular Procedures Feed
Single-fiber needle electromyography (EMG) with quantitative measurement of jitter, blocking, and/or fiber density at any/all sites of each muscle studied.
Modifiers 26 (professional component) and TC (technical component) may be applicable depending on who performs each component of the service.Refer to the CPT manual for appropriate modifier use.
Medical necessity for SFEMG is established when the physician has a clinical indication suggesting a neuromuscular junction disorder (e.g., myasthenia gravis, Lambert-Eaton myasthenic syndrome). The test provides crucial information to differentiate between various disorders.
The physician or qualified healthcare professional inserts the needle electrode, records the electrical signals, interprets the waveforms, and generates a report detailing the findings.This includes assessing jitter, blocking, and fiber density to diagnose neuromuscular junction disorders.
- Medicine Services and Procedures > Neurology and Neuromuscular Procedures
- Electromyography (EMG) Procedures
In simple words: This test uses a tiny needle electrode inserted into a muscle to measure its electrical activity.It helps diagnose muscle and nerve problems, especially myasthenia gravis, by checking for irregularities in how the nerve signals the muscle.
Single-fiber needle electromyography (SFEMG) involves recording and analyzing electrical signals from individual muscle fibers within motor units, both at rest and during voluntary contraction.A specialized needle electrode with a small recording surface is inserted into the muscle to isolate the electrical activity of specific muscle fibers.The procedure quantifies parameters such as jitter (irregularity of neuromuscular transmission), blocking (transmission failure), and fiber density.These measurements help diagnose neuromuscular disorders, particularly myasthenia gravis.
Example 1: A patient presents with fluctuating muscle weakness and fatigue, suggestive of myasthenia gravis.SFEMG of the facial muscles (orbicularis oculi, orbicularis oris) is performed to assess neuromuscular transmission.Elevated jitter and/or blocking would support the diagnosis., A patient with suspected Lambert-Eaton myasthenic syndrome undergoes SFEMG of the limb muscles to evaluate presynaptic dysfunction.The test measures changes in the amplitude and waveform characteristics of the muscle action potentials., A patient presents with a progressive muscle disorder of unknown etiology. SFEMG of various muscles (extremities, paraspinal muscles) provides detailed assessment of muscle fiber function and helps differentiate various forms of muscle diseases.
* Detailed patient history including symptoms and duration of symptoms* Thorough neurological examination findings* Identification of muscles tested and location of needle electrode insertions* Quantitative measurement of jitter, blocking, and/or fiber density for each muscle tested* Detailed interpretation of the results, correlating with the clinical presentation.
** Specific documentation requirements and coding rules may vary by payer. Always refer to payer-specific guidelines for accurate billing and reimbursement.
- Revenue Code: P6C (Medicare Fee Schedule: MINOR PROCEDURES - OTHER)
- RVU: Refer to the CMS fee schedule for current Relative Value Units (RVUs) and reimbursement rates.These values vary based on geographic location and other factors.
- Global Days: The global period for this procedure is not explicitly defined in the provided data.Refer to payer-specific guidelines for the applicable global period.
- Payment Status: Active
- Modifier TC rule: Modifier TC may be used for the technical component if billed separately; this is dependent upon the setting and payer.
- Fee Schedule: Refer to CMS fee schedules for historical payment rates. Note that these values are subject to changes over time.
- Specialties:Neurology, Neuromuscular Medicine
- Place of Service:Office, Hospital (Inpatient/Outpatient), Ambulatory Surgical Center, Other clinical settings as appropriate