Summary & Overview
CPT 95976: Cranial Nerve Neurostimulator Interrogation and Simple Programming
CPT code 95976 represents the clinical service of analyzing the function of an implanted cranial nerve neurostimulator system and performing simple or minor programming adjustments. This code is used when a physician or other qualified healthcare professional interrogates the device to evaluate lead performance, stimulation parameters, and overall device function, then makes straightforward parameter changes. Nationally, accurate reporting of this code supports appropriate payment for device management and informs utilization of neuromodulation therapies for conditions treated with cranial nerve stimulation.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for use of this code, typical sites of service, and payer coverage considerations. The publication also summarizes common modifiers observed with device-management services, notes where input was not provided, and outlines the policy and billing themes relevant to neuromodulation device interrogation. This resource is intended to help billing managers, clinicians, and policy analysts understand the purpose of CPT code 95976, the care setting where it is typically reported, and the primary payer landscape for national-level considerations.
Data not available in the input for Associated Taxonomies, ICD-10 diagnoses, Related Codes, and Service Line.
Billing Code Overview
CPT code 95976 describes analysis of the function of a cranial nerve neurostimulator system with simple or minor programming adjustments performed by a physician or other qualified healthcare professional. This service entails interrogation of an implanted cranial nerve stimulation device to assess lead integrity, stimulation parameters, and device function, followed by straightforward reprogramming or parameter tweaks as needed.
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Service type: Device interrogation and simple/minor programming
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Typical site of service: Outpatient clinic, physician office, or ambulatory surgical center where neurostimulation devices are managed
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with an implanted cranial nerve neurostimulator (for example, a vagus nerve stimulator) who presents for routine follow-up to assess device function and to make minor, noncomplex adjustments. The visit is scheduled in an outpatient neurology or neurosurgery clinic or an ambulatory device clinic. The clinician (a neurologist, neurosurgeon, or pain management physician) interrogates the neurostimulator using the manufacturer programmer, reviews patient symptom response and device telemetry, documents lead impedances and battery status, and makes simple parameter changes such as adjusting pulse width, amplitude, or basic mode settings. The encounter typically lasts 15–30 minutes and does not involve complex reprogramming, surgical revision, or lead manipulation. Common scenarios include routine device checks, patient-reported worsening of symptoms prompting minor amplitude changes, or scheduled battery and lead surveillance. The setting is commonly an outpatient clinic, ambulatory surgical center for device-related visits, or hospital outpatient department when performed during an inpatient stay for concurrent care.
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 a distinct E/M visit is performed in addition to the device analysis and simple programming. |
| 26 | Professional component | Use when billing only the physician's professional component separate from a technical component billed by a facility or device vendor.