A recent decision by the Centers for Medicare and Medicaid Services (CMS) will prevent neurologists from reporting more than one intraoperative monitoring case simultaneously. Rather than recognizing two new Current Procedural Terminology (CPT) codes to report intraoperative neurophysiologic monitoring services (95940, 95941) as listed in the 2013 American Medical Association (AMA) CPT code book, CMS instead accepted 95940, but created a G–code to replace 95941:
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)
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)
Continuous intraoperative neurophysiology monitoring from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes
The AAN is working closely with stakeholders like the American Clinical Neurophysiology Society (ACNS) to secure a meeting with CMS to work on a solution that would address the problems created by the introduction of this g–code.
The AAN also updated and shared our model medical coverage policy on intraoperative monitoring services with more than 25 national commercial payers, urging acceptance and use of 95940, 95941 rather than the g–code created by CMS.
Interested members should be aware that ACNS has scheduled two community conference calls to allow intraoperative monitoring physicians an opportunity to discuss the issue in depth.
The announcement came November 1st as part of CMS's Final Ruling on the 2013 Medicare Fee Schedule.