2025 CPT code 95875
(Active) Effective Date: N/A Revision Date: N/A Medicine - Ischemic Muscle Testing Procedures and Guidance Procedures for Chemodenervation Neurology and Neuromuscular Procedures Feed
Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s).
Modifiers 26 (professional component) and TC (technical component) may be appended as appropriate.Refer to current CPT guidelines for appropriate modifier usage. Modifier 59 (distinct procedural service) might be used in specific scenarios, but requires careful clinical justification.
Medical necessity is established when the ischemic limb exercise test is used to evaluate muscle metabolism and aid in the diagnosis of metabolic myopathies (like McArdle disease) or peripheral artery disease (PAD).The test should be ordered when the physician's clinical assessment supports a need to evaluate these conditions.
The physician or qualified healthcare professional is responsible for inducing ischemia, directing the patient's exercise, collecting blood samples, analyzing the results, and generating a report.
- Neurology and Neuromuscular Procedures
- Ischemic Muscle Testing Procedures and Guidance Procedures for Chemodenervation
In simple words: The doctor restricts blood flow to your arm and asks you to exercise (like repeatedly clenching your fist).They then take several blood samples to check for certain substances that indicate how well your muscles are working. This test helps diagnose muscle problems.
This procedure involves inducing ischemia in a limb (usually the forearm) and having the patient perform specific exercises.Serial blood samples are then collected to measure muscle metabolites (like lactic acid) at various intervals.This analysis helps assess muscle function and diagnose conditions like McArdle disease, a metabolic myopathy characterized by an inability to break down glycogen in muscles.
Example 1: A patient presents with unexplained muscle weakness and fatigue. The ischemic forearm exercise test is performed to assess for McArdle disease, as elevated lactic acid levels during exercise would suggest a problem with glycogen breakdown., A patient with suspected peripheral artery disease (PAD) undergoes the ischemic limb exercise test to evaluate blood flow restriction in their lower extremity.Changes in metabolite levels during and after exercise can indicate the severity of the PAD., A patient with a known metabolic myopathy undergoes serial ischemic limb exercise tests to monitor disease progression and response to treatment.Trends in metabolite levels over time provide valuable insights.
* Detailed patient history including symptoms, family history of muscle disorders, and relevant medications.* Documentation of the method of inducing ischemia (e.g., blood pressure cuff inflation pressure and duration).* Precise description of the exercise protocol performed by the patient.* Recording of the time points for blood sample collection.* Detailed laboratory results of muscle metabolite levels (e.g., lactic acid, creatine kinase).* Physician interpretation of the test results and clinical correlation.
** Accurate coding requires meticulous attention to detail, including specific exercise protocols, ischemia induction method, and precise recording of blood sampling times and results.Any deviations from standard protocols should be thoroughly documented.
- Revenue Code: P6C (Medicare Fee Schedule: MINOR PROCEDURES - OTHER)
- RVU: Data not available.RVUs vary based on geographic location, facility type, and other factors. Consult your local Medicare fee schedule.
- Global Days: Global period information not specified. Consult current CPT guidelines.
- Payment Status: Active
- Modifier TC rule: Modifier TC may be applied if only the technical component of the service was performed.Modifier 26 is appropriate when only the professional component is reported.
- Fee Schedule: Historical fee schedule data not available.Consult your local payer for specific historical fee information.
- Specialties:Neurology, Clinical Neurophysiology
- Place of Service:Office, Hospital Outpatient, Ambulatory Surgical Center