2025 CPT code 95921
(Active) Effective Date: N/A Revision Date: N/A Neurology - Autonomic Function Testing Procedures Medicine Services and Procedures > Neurology and Neuromuscular Procedures Feed
Evaluates the parasympathetic function of the autonomic nervous system using at least two of the following: heart rate response to deep breathing, Valsalva ratio, and 30:15 ratio.
Modifiers 26 (professional component), 52 (reduced services), and TC (technical component) may be applicable depending on the services provided and the payer's guidelines.
Autonomic function testing, including 95921, is medically necessary when indicated by symptoms suggestive of autonomic dysfunction, such as orthostatic hypotension, syncope, or gastrointestinal motility disorders. The tests help in differentiating between various types of autonomic neuropathies and guiding treatment decisions.
The physician or qualified healthcare professional is responsible for performing the tests, interpreting the results, and generating a report. This includes proper patient preparation, equipment setup, data acquisition using ECG, calculations of ratios, and analysis of heart rate responses.
- Medicine Services and Procedures > Neurology and Neuromuscular Procedures
- Neurology and Neuromuscular Procedures > Autonomic Function Testing Procedures
In simple words: This test checks how well the part of your nervous system that controls involuntary actions (like heart rate) is working. It involves measuring your heart rate during deep breaths, a special breathing technique (Valsalva maneuver), and while standing.The doctor uses an ECG to track your heart rhythm and calculate specific ratios to assess function.
This CPT code encompasses testing of the autonomic nervous system's cardiovagal (parasympathetic) innervation.The procedure involves a quantitative assessment of the heart rate response to at least two of the following: deep breathing (recorded R-R interval), Valsalva maneuver (calculating the Valsalva ratio), and the 30:15 ratio (derived from R-R intervals at beats 15 and 30). Electrocardiographic (ECG) monitoring is essential to record heart rate for subsequent waveform analysis.The test typically involves the patient in the prone position; a tilt table might be used but isn't mandatory for assessing parasympathetic function.
Example 1: A patient presents with symptoms suggestive of orthostatic hypotension (dizziness upon standing).95921, specifically the 30:15 ratio component, is used to assess the parasympathetic response to postural changes., A patient with suspected autonomic neuropathy related to diabetes mellitus undergoes 95921 testing to quantify the impairment of cardiovagal innervation. Deep breathing and Valsalva maneuver components are utilized., A patient experiencing unexplained syncope (fainting) undergoes autonomic function testing, including 95921 to evaluate parasympathetic function using all three test components (deep breathing, Valsalva ratio, and 30:15 ratio).
Detailed patient history including symptoms, medications, and relevant medical conditions.ECG tracing showing heart rate response to each test component. Calculations of Valsalva ratio and 30:15 ratio.Physician's interpretation and report.
** The accuracy of the test results can be affected by factors such as medications, age, and underlying medical conditions.Proper patient preparation and standardized procedures are crucial for reliable results.Refer to current CPT guidelines and payer-specific requirements for accurate billing.
- Revenue Code: T2D (OTHER TESTS - OTHER)
- Payment Status: Active
- Modifier TC rule: Modifier TC is applicable if only the technical component of the testing (ECG recording and data acquisition) is performed by the facility.
- Specialties:Neurology, Cardiology
- Place of Service:Office, Hospital (Inpatient/Outpatient), Ambulatory Surgical Center