The Dawn Cook DifferenceCredentials | Experience | Accreditations

What to expect on Medical Bills for neuromonitoring in Spine Surgery

If you see a bill for neuromonitoring, you may be wondering what all the codes are for and were they all needed.

Surgeries:

Neuromonitoring is used during neurosurgical procedures to monitor the functioning of structures such as nerves, the brain or the spinal cord.

Neuromonitoring provides:

  • Early warning to surgeons if there is damage about to occur
  • Allows for location of structures that can’t be visualized
  • Can detect or provide feedback on the success of decompression on nerve roots

Terminology

  • Intraoperative Neuromonting (IONM)
  • Somatosensory Evoked Potentials (SSEP)
  • Electromyograph (EMG)
  • Train of Four (TOF)
  • Pedicle Screw Stimulation (PSS)
  • Total Intravenous Anesthetic (TIVA)

The American Society of Neurophysiological Monitoring, recommends CPT code 95940 for continuous intraoperative neurophysiology monitoring in the operating room CPT code 95941 for outside of the operating room and Medicare code G0453.

Medtronic, Inc. (2015), noted that the American Medical Association recommends the same codes mentioned above and also CPT code 95868 for needle electromyography; cranial nerve and CPT 95870 for needle electromyography of muscles in extremity or non-limb.

References:

Susan[MOU1]  Yatvin, BSN. (2019 Spring). Understanding the Role of Neuromonitoring in Spine Surgery. The Journal of Legal Nurse Consulting, 30(1), p.30-33.

The American Society of Neurophysiological Monitoring. Retrieved from www.asnm.org 

Medtronic, Inc. (2015). Intraoperative Nerve Monitoring: reimbursement coding guide.  Retrieved from www.medtronicent.com