Summary & Overview
CPT 95909: Nerve Conduction Study, Five to Six Tests
CPT code 95909 describes a diagnostic nerve conduction study comprising five or six individual conduction tests to evaluate motor and sensory nerve function. Nerve conduction studies are central to diagnosing peripheral neuropathies, nerve entrapments, and monitoring neuromuscular disease progression, making this code important for neurology, physiatry, and electrodiagnostic services nationwide. Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find clinical context for when a multi-test nerve conduction study is used, the typical service setting, and operational considerations relevant to billing and coverage. The publication presents benchmark information on utilization and payment patterns, highlights common documentation elements needed for medical necessity, and summarizes recent policy updates affecting coverage and claim adjudication for electrodiagnostic services. The goal is to give clinicians, coders, and administrators a concise reference on CPT code 95909 for coding accuracy, coverage expectations, and integration into clinical workflows.
Billing Code Overview
CPT code 95909 represents a diagnostic nerve conduction study (NCS) in which the provider performs five or six nerve conduction studies to evaluate the electrical conduction of motor and sensory nerves. This procedure assesses nerve function and helps diagnose peripheral neuropathies, entrapment neuropathies, and other neuromuscular disorders.
Service type: Diagnostic electrodiagnostic testing (nerve conduction studies)
Typical site of service: Electrodiagnostic laboratory, neurology clinic, or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A 54-year-old patient presents to an outpatient neurology clinic with progressive distal numbness, paresthesia, and intermittent hand weakness over several months. The neurologist performs a focused neuromuscular evaluation and orders electrodiagnostic testing to differentiate compressive neuropathy, demyelinating polyneuropathy, or axonal peripheral neuropathy. The clinical workflow includes pre-procedure screening for contraindications (e.g., implanted cardiac devices), informed consent, site selection and skin preparation, performance of multiple sensory and motor nerve conduction studies (five to six nerves per CPT 95909), documentation of limb temperature and technical parameters, interpretation of latency, amplitude, and conduction velocity results, and generation of a diagnostic report for the referring provider. Typical sites of service are outpatient neurology clinics, hospital outpatient departments, and ambulatory surgery centers. The procedure evaluates both sensory and motor nerve function and guides further management such as EMG, imaging, or referral to physical therapy or surgery.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use when an E/M visit is performed on the same day as for evaluation of a new or worsening condition distinct from the procedure |