Intraoperative neurophysiological monitoring

Applies to:

All plans

Definition

Intraoperative neurophysiological monitoring (IONM) uses methods such as electroencephalography (EEG) and electromyography (EMG) to monitor the functional integrity of a patient's nerves, spinal cord, blood supply and parts of the brain during surgery. The purpose of IONM is to reduce the risk of damage to the patient and to provide guidance to the surgeon and anesthesiologist.

Intraoperative neurophysiological monitoring billing

Payable:

For all plans, Priority Health reimburses CPT code 95940 and HCPCS code G0453 as outlined within the Medicare WPS Local Coverage Determination (LCD) policy L34623. Review the LCD policy L34623 for additional information.

• 95940: Continuous intraoperative neurophysiology monitoring in the operating room, one on one monitoring requiring personal attendance, each 15 minutes (list separately in addition to code for primary procedure)
• G0453: Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient (attention directed exclusively to one patient), each 15 minutes (list in addition to primary procedure)

Not payable:

CPT code 95941: Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby) or for monitoring of more than one case while in the operating room, per hour (list separately in addition to code for primary procedure)