2025 CPT code 95971
(Active) Effective Date: N/A Revision Date: N/A Neurology - Neurology and Neuromuscular Procedures Medicine Services and Procedures Feed
Electronic analysis with simple programming of an implanted spinal cord or peripheral nerve neurostimulator.
Modifiers 26 (professional component), 53 (discontinued procedure), 59 (distinct procedural service) may be applicable in certain circumstances.Refer to the complete modifier guidelines.
Medical necessity for 95971 is established by the presence of a previously implanted spinal cord or peripheral nerve neurostimulator, documented symptoms requiring parameter adjustment, and the physician's determination that the programming adjustments are medically necessary to optimize the patient's therapy. This could be based on symptoms reported by the patient or objective data like improvement or worsening of physiological measures.
The physician or other qualified healthcare professional is responsible for reviewing the neurostimulator's parameters, ensuring proper function, and making necessary adjustments to optimize the patient's therapy. This includes analyzing system settings (impedances, etc.) and making adjustments to parameters such as amplitude, pulse width, frequency etc. to address the patient’s clinical needs.
In simple words: The doctor checks a device implanted in your spine or nerves to make sure it's working correctly and makes a few small adjustments to improve treatment.
This CPT code encompasses the electronic analysis of an implanted spinal cord or peripheral nerve neurostimulator pulse generator/transmitter, along with simple programming adjustments.Simple programming involves modifying one to three parameters of the device.Parameters may include, but aren't limited to: contact group(s), interleaving, amplitude, pulse width, frequency (Hz), on/off cycling, burst, magnet mode, dose lockout, patient-selectable parameters, responsive neurostimulation, detection algorithms, closed-loop parameters, and passive parameters.The analysis ensures proper device function, and programming optimizes therapeutic delivery based on patient response.
Example 1: A patient with chronic pain due to spinal stenosis undergoes implantation of a spinal cord stimulator.Post-implantation, 95971 is used to assess the device’s settings and make minor adjustments to the amplitude and pulse width to optimize pain relief. , A patient with overactive bladder receives a sacral nerve stimulator.During a follow-up visit, the physician performs electronic analysis (95971) to evaluate device function and adjust the stimulation frequency to address persistent bladder urgency. , A patient with peripheral neuropathy has an implanted peripheral nerve stimulator.The patient experiences altered sensation, and the physician performs 95971 to analyze device parameters and make minor adjustments to improve therapy.
Detailed documentation should include the pre-programming parameters, the adjustments made, the post-programming parameters, the rationale for the adjustments made, and the patient's response to the adjustments.Physician's notes should clearly indicate the number of parameters adjusted.Device reports generated by the neurostimulator should be included.
** This code is specifically for simple programming (1-3 parameters).For more extensive programming adjustments, use code 95972.The electronic analysis is inherent to the procedure; it should not be separately coded at the time of device implantation.Test stimulations are not considered part of this procedure.
- Revenue Code: T2D (OTHER TESTS - OTHER)
- Payment Status: Active
- Modifier TC rule: Modifier TC (technical component) is not applicable to 95971, as the code represents professional services.
- Specialties:Neurology, Neurosurgery, Pain Management
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center