2025 CPT code 95864
(Active) Effective Date: N/A Revision Date: N/A Neurology - Electromyography Medicine Services and Procedures > Neurology and Neuromuscular Procedures Feed
Needle electromyography of four extremities with or without related paraspinal areas.
Modifiers 26 (professional component) and TC (technical component) may apply depending on the circumstances. Modifier 59 (distinct procedural service) may be needed if multiple EMG procedures are performed.
Medical necessity for 95864 is established when there is clinical suspicion of neuromuscular disorders, such as muscle weakness, pain, atrophy, or abnormalities in reflexes.The test provides objective data to support a diagnosis and guide management.
Physicians specializing in Neurology, Neuromuscular Medicine, or Physical Medicine and Rehabilitation typically perform this procedure.The clinical responsibility includes inserting the needle electrodes, recording and interpreting the EMG signals, and generating a report.
- Medicine Services and Procedures > Neurology and Neuromuscular Procedures
- Neurology and Neuromuscular Procedures
In simple words: This test uses tiny needles to check the electrical signals in muscles of all four limbs (arms and legs), possibly including muscles along the spine. It helps diagnose muscle and nerve problems.
This CPT code, 95864, represents needle electromyography (EMG) encompassing four extremities, with the option to include related paraspinal muscle areas.The procedure involves inserting needle electrodes into muscles to record their electrical activity during rest and contraction.The recorded waveforms are analyzed to diagnose neuromuscular disorders.The paraspinal areas included are all except those of the thoracic region (T3-T11). If thoracic paraspinal muscles (excluding T1 or T12) are studied, code 95869 should be used additionally.A minimum of five muscles per limb must be studied.
Example 1: A patient presents with progressive muscle weakness in all four limbs.A 95864 is performed to assess the electrical activity of muscles in both upper and lower extremities to identify the cause of weakness (e.g., myopathy, neuropathy)., A patient with chronic low back pain undergoes a comprehensive EMG study (95864) including paraspinal muscles to evaluate for potential nerve root compression or myofascial involvement contributing to their pain., A patient with suspected Guillain-Barré syndrome has 95864 performed to evaluate the extent of peripheral nerve involvement affecting the muscles in all four limbs.The results will help guide treatment and prognosis.
Detailed patient history, including symptoms, onset, duration, and progression of any neuromuscular symptoms.A detailed description of the procedure, including muscles studied, electrode placement, and findings.Interpretive report including diagnoses and recommendations.
** Always refer to the most current CPT codebook and coding guidelines for the most up-to-date information and potential updates to this code.
- Revenue Code: P6C (Medicare Fee Schedule: MINOR PROCEDURES - OTHER)
- Payment Status: Active
- Modifier TC rule: The TC modifier (technical component) applies only when the technical component is billed separately from the professional component.This is usually the case when the services are provided by different entities.
- Specialties:Neurology, Physical Medicine and Rehabilitation, Electromyography
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center, other clinical settings where EMG testing can be performed