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ICD-10 Guide
ICD-10 CodesR94.1

R94.1

Abnormal results of function studies of peripheral nervous system and special senses

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R94.1 is a billable code used to indicate a diagnosis of abnormal results of function studies of peripheral nervous system and special senses.

Key Diagnostic Point:

R94.1 is used to classify abnormal results from function studies that assess the peripheral nervous system and special senses, such as vision and hearing. These studies may include nerve conduction studies, electromyography (EMG), and various sensory tests. Abnormal findings can indicate a range of conditions, including neuropathies, myopathies, and sensory deficits. Symptoms may include numbness, tingling, weakness, or sensory loss, which can significantly impact a patient's quality of life. The clinical context for this code often involves patients presenting with unexplained neurological symptoms, prompting further investigation through specialized testing. Accurate coding requires a thorough understanding of the underlying conditions that may lead to abnormal test results, as well as the specific tests performed and their outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of tests that can yield abnormal results
  • Need for precise documentation of test results
  • Differentiation from other neurological conditions
  • Potential overlap with other ICD codes

Audit Risk Factors

  • Inadequate documentation of test results
  • Failure to specify the type of function study performed
  • Misclassification of symptoms leading to incorrect coding
  • Lack of correlation between clinical findings and test results

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed documentation of patient history, symptoms, and specific tests performed, along with their results.

Common Clinical Scenarios

Patients presenting with unexplained neuropathic symptoms, requiring nerve conduction studies or EMG.

Billing Considerations

Ensure that all relevant clinical findings are documented to support the use of R94.1.

Emergency Medicine

Documentation Requirements

Acute care documentation must include immediate symptoms, test results, and any interventions performed.

Common Clinical Scenarios

Patients with acute onset of neurological symptoms requiring rapid assessment and testing.

Billing Considerations

Document the urgency of the situation and the rationale for testing to support coding.

Coding Guidelines

Inclusion Criteria

Use R94.1 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the code is used only when there are abnormal results from function studies
  • Document the specific tests performed and their outcomes to support the diagnosis

Exclusion Criteria

Do NOT use R94.1 When
No specific exclusions found.

Related CPT Codes

95900CPT Code

Nerve conduction studies

Clinical Scenario

Used when nerve conduction studies are performed to assess peripheral nerve function.

Documentation Requirements

Document the specific nerves tested and the results.

Specialty Considerations

Neurology specialists should ensure comprehensive documentation of findings.

95860CPT Code

Electromyography (EMG)

Clinical Scenario

When EMG is performed to evaluate muscle response.

Documentation Requirements

Document the muscles tested and any abnormal findings.

Specialty Considerations

Ensure that the clinical rationale for the EMG is clearly stated.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of abnormal findings, improving the granularity of data collection and analysis. R94.1 provides a clear classification for abnormal results from function studies, enhancing the ability to track and manage neurological conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of abnormal findings, improving the granularity of data collection and analysis. R94.1 provides a clear classification for abnormal results from function studies, enhancing the ability to track and manage neurological conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of abnormal findings, improving the granularity of data collection and analysis. R94.1 provides a clear classification for abnormal results from function studies, enhancing the ability to track and manage neurological conditions.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What types of tests are included under R94.1?

R94.1 includes results from nerve conduction studies, electromyography (EMG), and sensory testing for vision and hearing.

Can R94.1 be used for routine check-ups?

No, R94.1 should only be used when there are abnormal results from function studies that are clinically relevant.