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Stimulation-based functional mapping

Luz Posted Thu 03rd of March, 2016 15:19:37 PM

I need help finding a CPT code for this procedure; we were advised to use 96118, but I do not feel comfortable with this code. See description of procedure below:

your input is Cortical mapping is an invasive procedure in which electrical stimulation is applied briefly to discrete areas of the cortical surface for the purpose of identifying areas critical for sensory, motor or cognitive function (most often language; however, nonverbal cognitive and/or memory functions can be mapped as well). This procedure is utilized when brain surgery involves the removal or disruption of potentially functional brain areas. Sites identified via cortical mapping are typically spared from resection, with the goal of preserving function postoperatively.

Stimulation is applied using a bipolar stimulator, usually via pairs of adjacent subdural electrodes. Typically, the neuropsychologist tests the patient during the brief period of stimulation at multiple sites (one at a time); while someone else (typically neurologist or neurosurgeon) controls the stimulator.

The procedure can be conducted intra-operatively in a conscious patient before resection of brain tissue, or extra-operatively, if subdural electrodes have been implanted, most commonly in pharmacologically resistant epilepsy patients who require intracranial EEG monitoring to delineate the region of seizure onset and spread. The identification of sensory and motor sites is based on stimulation-evoked "positive" responses, such as a subjective sensation (e.g., tingling) or an observable movement (e.g., muscle twitch). In contrast, stimulation of cognitive/language cortex elicits no experiential or observable response in an inactive patient. Rather, cortical language mapping relies on "negative" responses, in that the patient must be engaged in a language task and stimulation of language cortex will disrupt task performance. Language cortex is functionally specific, so, depending on the brain location of surgery, different types of cognitive/language tasks must be used.

SuperCoder Answered Fri 04th of March, 2016 03:17:16 AM

Use CPT code 95961.

CPT code 95961 is for functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional.

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