Find policies, billing codes, payers, states, and providers
CPT 95875: Ischemic Exercise Test for Metabolic Muscle Disorders
CPT code 95875 denotes an induced ischemic exercise test, most commonly the ischemic forearm test, used to evaluate metabolic muscle disorders such as McArdle disease. This specialized diagnostic procedure recreates ischemic conditions while the patient performs exercise to evaluate muscle metabolic responses. Nationally, it is an important tool for confirming rare metabolic myopathies and guiding clinical care and genetic evaluation.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise explanation of clinical indications and the typical care setting, as well as operational context for billing and common modifier use (listed separately). The publication provides benchmarks and coverage patterns where available, policy interpretations that affect claims processing, and practical notes on site-of-service considerations for outpatient neuromuscular testing.
This summary is designed for clinicians, billing professionals, and policy analysts seeking a national overview of CPT code 95875, including clinical context, payer coverage scope, and what to expect when documenting and submitting claims for ischemic exercise metabolic testing.
Customize your policy alerts
Sign up for cpt 95875 policy alerts
Get alerted when payer policies referencing 95875 are released or updated.
Monitor payer policy activity
Billing Code Overview
CPT code 95875 describes a diagnostic procedure in which a provider has the patient perform exercise under induced ischemic conditions. The test is most commonly the ischemic forearm exercise test used to evaluate metabolic muscle disorders such as McArdle disease. This procedure assesses muscle metabolic response to exercise when blood flow is occluded, measuring biochemical and clinical responses.
-
Service type: Diagnostic metabolic/exercise testing
-
Typical site of service: Hospital outpatient clinic, specialty neuromuscular or metabolic testing laboratory, or ambulatory surgical center with appropriate monitoring capabilities