Summary & Overview
CPT 0767T: Peripheral Nerve Magnetic Stimulation, Additional Nerve
CPT code 0767T represents noninvasive magnetic stimulation of a peripheral nerve performed as an add-on service for each additional nerve treated during the same encounter. The procedure involves locating the peripheral nerve, determining appropriate magnetic stimulation amplitude, and may include nerve conduction testing to confirm localization. Nationally, this code is relevant as neuromodulation and noninvasive nerve stimulation techniques expand across outpatient and ambulatory care settings.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines typical coverage considerations and benchmarking context for these major payers and Medicare, recognizing variation in coverage policies and utilization management approaches.
Readers will learn the clinical purpose and billing context of CPT code 0767T, where the service is typically performed, and which payers are commonly involved. The report summarizes benchmark metrics and policy considerations relevant to reimbursement and claim adjudication, provides clinical context for appropriate use, and identifies where data was not available in the input. Data not available in the input includes payer-specific coverage criteria, associated taxonomies, ICD-10 diagnoses, related codes, and service-line details beyond the provided description.
Billing Code Overview
CPT code 0767T describes a procedure in which the provider locates a peripheral nerve for treatment and defines the appropriate magnetic stimulation amplitude. The provider may use nerve conduction testing to confirm nerve location. The service consists of noninvasive magnetic stimulation of a peripheral nerve and this code applies to each additional nerve treated after the first at a single encounter.
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Service type: Noninvasive peripheral nerve magnetic stimulation localization and amplitude determination for additional nerves
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Typical site of service: Outpatient clinic or ambulatory procedure setting where noninvasive neuromodulation procedures are performed
Clinical & Coding Specifications
Clinical Context
A 55-year-old patient with chronic peripheral neuropathic pain localized to the distribution of the superficial peroneal nerve presents to an outpatient neuromodulation clinic after conservative measures failed. The provider performs a focused evaluation, explains the noninvasive peripheral magnetic stimulation treatment plan, and selects the target peripheral nerve. During the visit the provider locates the nerve using anatomical landmarks and may confirm localization with nerve conduction testing. The provider titrates magnetic stimulation amplitude to define the therapeutic threshold and documents patient response and any immediate adverse effects. If multiple nerves are treated in the same encounter, 0767T is reported for each additional nerve after the first. Typical sites of service include outpatient hospital-based procedural suites or freestanding ambulatory surgical centers; the service is performed with the patient awake, positioned for access to the targeted peripheral nerve, and with monitoring per facility policy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the work performed is substantially greater than normally required for 0767T due to complexity or complications. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as described. |
53 | Discontinued procedure | Use when the procedure is started but halted due to patient instability or other uncontrollable circumstances. |
54 | Surgical care only | Use when the provider billed only for the procedural component and not pre/postoperative care (rare for this noninvasive service). |
55 | Postoperative management only | Use when billing only for postoperative care separate from the procedure. |
56 | Preoperative management only | Use when billing only for preoperative care when another clinician performs the procedure. |
62 | Two surgeons | Use when two surgeons of different specialties work together as primary surgeons on the procedure. |
66 | Surgical team | Use when an organized surgical team performs the procedure. |
78 | Unplanned return to the operating/procedure room by the same physician following the initial procedure for a related procedure during the postoperative period | Use if the patient requires an unplanned additional procedure related to the initial treatment during the global period. |
80 | Assistant surgeon | Use when an assistant surgeon is documented and payment policies allow assistant billing. |
81 | Minimum assistant surgeon | Use when a minimum assistant surgeon is documented and payer accepts this modifier. |
82 | Assistant surgeon when a qualified resident is unavailable | Use when an assistant surgeon is required and a resident is not available. |
73 | Discontinued outpatient hospital/ambulatory surgery prior to anesthesia administration | Use when the outpatient procedure is cancelled before anesthesia (applicable if planned sedation or anesthesia was scheduled). |
53 | Discontinued procedure (duplicate entry for emphasis) | See above; used when procedure is abandoned. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
2084P0800X | Physical Medicine & Rehabilitation | Providers performing neuromodulation and peripheral nerve stimulation protocols. |
208M00000X | Neurology | Neurologists who perform diagnostic nerve localization and noninvasive neuromodulation. |
207R00000X | Pain Medicine | Pain medicine specialists delivering targeted peripheral nerve stimulation therapies. |
207L00000X | Anesthesiology | Anesthesiologists involved when sedation or procedure support is required. |
208100000X | Physical Therapist (clinical specialist) | Clinicians who may participate in therapy planning and stimulation parameter titration. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
G58.0 | Complex regional pain syndrome | Peripheral magnetic stimulation may be used as part of neuromodulation strategies for focal neuropathic pain syndromes. |
G56.0 | Carpal tunnel syndrome | Targeted peripheral nerve interventions and localization techniques apply for entrapment neuropathies when noninvasive neuromodulation is considered. |
G57.0 | Sciatica | Peripheral nerve-targeted therapies can be applied for focal radicular or neuropathic pain when conservative therapy fails. |
G62.9 | Polyneuropathy, unspecified | Peripheral magnetic stimulation can be trialed for symptomatic focal neuropathic pain in selected patients. |
M79.2 | Neuralgia and neuritis, unspecified | Common indication for targeted peripheral nerve stimulation to reduce focal neuropathic pain symptoms. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
95905 | Nerve conduction, amplitude and latency/velocity study, each nerve; motor or sensory, with F-waves when performed | Often used to confirm nerve localization prior to or during 0767T when nerve conduction confirmation is performed. |
95907 | Needle electromyography; complete, each extremity (excluding thoracic paraspinal) | May be used adjunctively in diagnostic evaluation of neuropathy prior to peripheral nerve stimulation planning. |
97024 | Application of a modality to 1 or more areas; traction, mechanical | May be part of multimodal conservative management before proceeding to peripheral nerve stimulation. |
64555 | Percutaneous implantation of neurostimulator electrode array; peripheral nerve (e.g., auricular, other peripheral) | Represents an implanted neurostimulation option that may be considered when noninvasive magnetic stimulation is ineffective. |
99441 | Phone evaluation and management service by a physician or other qualified health care professional, 5-10 minutes of medical discussion | Used for pre- or post-procedure communications related to management of symptoms or treatment planning. |