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2025 CPT code 95866

Needle electromyography of the hemidiaphragm.

Follow CPT coding guidelines for electromyography (EMG) procedures. The interpretation and report by a physician or other qualified healthcare professional are integral parts of the code.

Modifiers 26 (professional component) and TC (technical component) may be applicable depending on who performed the procedure and the payment arrangements.

Hemidiaphragm needle EMG is medically necessary when there is clinical suspicion of diaphragmatic dysfunction, such as unexplained dyspnea, respiratory weakness, or imaging findings suggesting diaphragmatic paralysis.It is also medically necessary to monitor disease progression in patients with known neuromuscular disorders affecting the diaphragm.

The clinical responsibility for performing a hemidiaphragm needle EMG rests with a physician specializing in neurology, neuromuscular medicine, or other qualified healthcare professional trained in performing this procedure and interpreting its results. This includes inserting the needle electrode, recording the electrical activity, and interpreting the waveforms to diagnose underlying neuromuscular conditions.

IMPORTANT:For needle electromyography of the anal or urethral sphincter, use 51785. For non-needle electromyography of the anal or urethral sphincter, use 51784. For needle electromyography of the larynx, use 95865. For needle electromyography of extra-ocular muscles, use 92265.

In simple words: This test uses thin needles with electrodes to check the electrical activity of one half of the diaphragm muscle while you breathe normally.This helps doctors understand why you might be having trouble breathing.

Needle electromyography (EMG) of the hemidiaphragm involves inserting a needle electrode into the muscle of one half of the diaphragm to record and analyze the electrical activity of muscle cells during spontaneous respiration.The procedure helps diagnose and evaluate diaphragmatic dysfunction by identifying neuropathies or myopathies affecting the diaphragm, complementing information from phrenic nerve conduction studies. This procedure is useful in the diagnosis and prognosis of patients with diaphragmatic dysfunction and provides valuable information concerning disorders that may affect the diaphragm.

Example 1: A patient presents with unexplained dyspnea and weakness.A chest X-ray reveals unilateral hemidiaphragmatic elevation.A hemidiaphragm needle EMG is performed to assess for diaphragmatic paralysis or other neuromuscular disorders affecting the diaphragm., A patient recovering from a stroke experiences respiratory difficulty.The physician orders a hemidiaphragm needle EMG to evaluate if the stroke has caused damage to the phrenic nerve or diaphragm muscle, contributing to the patient's breathing problems., A patient with known amyotrophic lateral sclerosis (ALS) experiences worsening respiratory symptoms. A hemidiaphragm needle EMG is ordered to monitor disease progression and assess the severity of diaphragmatic involvement.

** This procedure may be performed in conjunction with phrenic nerve conduction studies, in which case the physician may need to use alternative codes according to the CPT guidelines for the study of multiple sites. Note also, that the interpretation alone could be coded with modifier 26.

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