2025 CPT code 95976
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Neurology - Neurostimulator Programming Medicine Services and Procedures > Neurology and Neuromuscular Procedures Feed
Electronic analysis of an implanted cranial nerve neurostimulator with simple programming (1-3 parameters) by a physician or qualified professional.
Modifiers may be applicable depending on the circumstances of the service (e.g., modifier 26 for professional component only, modifiers 59, 76, 77, etc., as appropriate).
Medical necessity is established by documenting the patient's symptoms related to the neurostimulator's function (e.g., inadequate seizure control, persistent depression symptoms, unresolved sleep apnea). The adjustments made to the device parameters must be justified by the patient's clinical presentation and response to prior therapy.The documentation should support the need for a simple, not complex, programming adjustment.
The physician or qualified healthcare professional is responsible for analyzing the implanted neurostimulator's functionality, assessing its parameters, and making necessary adjustments to optimize its therapeutic effect. This involves a thorough understanding of the device's settings and their impact on the patient's condition.
- Medicine Services and Procedures > Neurology and Neuromuscular Procedures
- Neurostimulator Analysis and Programming
In simple words: The doctor or a qualified healthcare professional checks and makes a few small adjustments to a device implanted near a cranial nerve to help treat a medical condition. They test different settings and then make 1-3 changes to improve how the device works.
This CPT code, 95976, encompasses the electronic analysis of an implanted cranial nerve neurostimulator pulse generator/transmitter system.The analysis involves assessing various system parameters such as contact group(s), interleaving, amplitude, pulse width, frequency (Hz), on/off cycling, burst mode, magnet mode, dose lockout, patient-selectable parameters, responsive neurostimulation, detection algorithms, closed-loop parameters, and passive parameters. Following the analysis, simple programming adjustments are performed, involving the modification of one to three parameters.This procedure is performed by a physician or other qualified healthcare professional.
Example 1: A patient with epilepsy receives vagus nerve stimulation (VNS) therapy.The physician performs a routine check of the VNS device and makes minor adjustments to the pulse width and frequency to improve seizure control.This would be coded as 95976., A patient with treatment-resistant depression undergoes deep brain stimulation (DBS) using a cranial nerve stimulator. During a follow-up visit, the physician assesses the device's settings and modifies the amplitude and on/off cycle to enhance therapeutic benefit. This would be coded as 95976., A patient with obstructive sleep apnea (OSA) has a hypoglossal nerve stimulator implanted. During a follow-up appointment, the clinician analyzes the stimulator's parameters and adjusts the stimulation intensity and frequency to improve the patient's sleep quality and reduce apnea events. This would be coded as 95976.
Detailed documentation should include the pre-programming system settings and electrode impedances.The specific parameters adjusted during the programming session must be clearly documented, along with the rationale for each adjustment.Pre- and post-programming assessments of the patient's clinical condition should also be included to demonstrate medical necessity.Physician notes should confirm that only 1-3 parameters were adjusted.
** The number of parameters adjusted during a single session determines whether 95976 or 95977 is appropriate.If a parameter is adjusted multiple times in a single session, it counts as one parameter.Electronic analysis is inherent in implantation codes and is not separately reportable at the same operative session.
- Revenue Code: P1G (Major Procedure - Other)
- RVU: This information is not provided in the source.
- Global Days: Not applicable.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: This information is not provided in the source.
- Specialties:Neurology, Neurosurgery
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center