2025 CPT code 95977
(Active) Effective Date: N/A Revision Date: N/A Neurology - Neurostimulators Analysis-Programming Procedures Medicine Services and Procedures > Neurology and Neuromuscular Procedures Feed
Electronic analysis of an implanted cranial nerve neurostimulator with complex programming adjustments by a physician or qualified professional.
Modifiers may be applicable depending on the circumstances of the service. For example, modifier 59 (distinct procedural service) may be used if the programming is performed on a separate day and is not considered part of the initial implantation procedure. Other modifiers may apply depending on the location of service and physician involvement.
Medical necessity for 95977 is established when a patient with an implanted cranial nerve neurostimulator experiences inadequate symptom relief or adverse effects requiring complex programming adjustments to optimize therapeutic efficacy.The documentation must clearly demonstrate the need for such adjustments based on the patient's clinical response and the complexity of the programming required to address the specific symptoms.
The physician or qualified healthcare professional is responsible for analyzing the neurostimulator's function, adjusting multiple parameters to optimize therapy, and ensuring the device is correctly programmed to deliver consistent and appropriate treatment.
- Medicine Services and Procedures > Neurology and Neuromuscular Procedures
- Neurostimulators Analysis-Programming Procedures
In simple words: The doctor or a qualified healthcare professional checks and adjusts the settings of a device implanted near a cranial nerve to help treat a medical condition.The doctor makes multiple, significant adjustments to improve the device's function.
This CPT code encompasses the electronic analysis of an implanted cranial nerve neurostimulator pulse generator/transmitter system.The analysis involves evaluating various system parameters, including contact groups, interleaving, amplitude, pulse width, frequency (Hz), on/off cycling, burst mode, magnet mode, dose lockout, patient-selectable parameters, responsive neurostimulation features, detection algorithms, closed-loop parameters, and passive parameters. Following the analysis, complex programming is performed, involving adjustments to more than three parameters.A single parameter adjusted multiple times counts as one parameter. The procedure is performed by a physician or other qualified healthcare professional.
Example 1: A patient with vagus nerve stimulation (VNS) for treatment-resistant depression undergoes programming adjustments due to insufficient symptom relief. The physician performs a complex programming session, modifying more than three parameters to enhance stimulation efficacy., A patient with trigeminal neuralgia and an implanted trigeminal nerve stimulator experiences increased pain. The physician performs a complex programming adjustment to the stimulator parameters., Following implantation of a cranial nerve stimulator for the treatment of sleep apnea, the patient exhibits suboptimal response. The physician conducts a complex reprogramming session to fine-tune the stimulation parameters.
* Detailed pre-programming system analysis documenting settings and electrode impedances.* A record of all programming adjustments made during the session, including the values of each parameter before and after modification.* Documentation of the patient's clinical presentation and response to each adjustment.* Justification for each parameter change based on the patient's response and clinical goals.* Final programming parameters used, along with any specific instructions or recommendations to the patient.* Progress notes addressing patient symptoms, medication adjustments, and overall treatment plan.
** Ensure that the number of parameters adjusted during the programming session accurately reflects the complexity of the procedure.Proper documentation is crucial for appropriate code selection and reimbursement.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier does not apply to this code.This procedure is typically performed by the physician or other qualified healthcare professional.
- Specialties:Neurology, Neurosurgery
- Place of Service:Office, Hospital (Inpatient/Outpatient), Ambulatory Surgical Center