Question: Our Physician performed Intraoperative Neurophysiology Monitoring concurrently while performing a total thyroidectomy. We billed the CPT 60240 and 95920-26 but we have no luck in getting reimbursed for 95920-26. It is constantly getting denied as ‘an integral part of the primary service’. What did we do wrong?
Answer: Intraoperative neurophysiology monitoring is a procedure that describes the ongoing electrophysiologic testing and monitoring performed during surgical procedures. It should NOT be reported by the surgeon performing an operative procedure since it is bundled in the global package .The CPT 95920 is bundled with many operative procedure codes per National Corrective Coding Initiative edits. Therefore surgeon performing the operative procedure and/or assistant surgeon should not bill for neurophysiology testing codes for IONM testing, however, when IONM is performed by a second physician such as a neurologist or neurophysiologist it may be separately reportable according to NCCI.