2025 CPT code 95984
(Active) Effective Date: N/A Revision Date: N/A Neurology - Neurostimulator Programming Medicine Feed
Electronic analysis of an implanted brain neurostimulator with programming; each additional 15 minutes of face-to-face time.
Modifiers may be applicable depending on the circumstances of the service, such as modifier 59 for distinct procedural services or other modifiers as required by payer-specific rules. Consult payer-specific guidelines for appropriate modifier use.
Medical necessity is established when the programming session is deemed necessary to optimize the therapeutic benefits of the implanted neurostimulator and address the patient's clinical needs based on their response to the initial stimulation and clinical presentation. Documentation demonstrating the need for the reprogramming and clinical justification are crucial.
The physician or other qualified healthcare professional is responsible for analyzing the implanted brain neurostimulator's function, making necessary programming adjustments to optimize therapy, and documenting the changes and patient response.
In simple words: This code is for the doctor or other qualified healthcare professional to check and adjust a brain stimulator implant.It's used for each extra 15 minutes spent working directly with the patient after the first 15 minutes.
This CPT code, 95984, reports the electronic analysis of an implanted brain neurostimulator pulse generator/transmitter, including programming adjustments by a physician or qualified healthcare professional.It covers each additional 15-minute interval of face-to-face time beyond the initial 15 minutes (reported with code 95983).The analysis may involve assessing various parameters such as contact groups, interleaving, amplitude, pulse width, frequency, on/off cycling, burst mode, magnet mode, dose lockout, patient-selectable parameters, responsive neurostimulation, detection algorithms, closed-loop parameters, and passive parameters.Adjustments are made to optimize the device's therapeutic effect based on the patient's clinical presentation and response.
Example 1: A patient with Parkinson's disease undergoes programming adjustments to their deep brain stimulator due to worsening tremors. The physician spends an additional 30 minutes (two units of 95984) beyond the initial 15 minutes (95983) optimizing the stimulation parameters., A patient with epilepsy experiences changes in seizure frequency.The neurologist performs a programming session, spending an additional 45 minutes (three units of 95984) fine-tuning the parameters of the implanted neurostimulator to reduce seizure activity., Post-operative, a patient reports discomfort and reduced efficacy from their implanted brain stimulator. The neurologist spends an additional 15 minutes (one unit of 95984) to reprogram the device, addressing the reported issues.
Detailed documentation should include the pre-programming settings, the adjustments made to each parameter, the rationale for the changes, the patient's response to the adjustments, and the final programming parameters.Pre and post-programming assessments should be recorded to reflect the treatment response. Any relevant patient-reported outcomes should also be documented.
** Always refer to the most current CPT codebook and payer-specific guidelines for the most up-to-date information on coding and reimbursement policies.This information is for guidance only and should not be considered a substitute for professional medical coding advice.
- RVU: The relative value units (RVUs) for this code vary based on the location of service (physician office versus facility) and payer.Consult the appropriate fee schedule for current RVU values and reimbursement rates.
- Payment Status: Active
- Modifier TC rule: This code does not have a technical component (TC) modifier associated with it.
- Fee Schedule: Historical fee schedule data is unavailable.Consult the appropriate fee schedule database for historical and current reimbursement information.
- Specialties:Neurology, Neurosurgery
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Ambulatory Surgical Center