List of Nerves with Added Specificity

Appendix A

Codes 95900 and 95903 involve the following nerves:

1. Upper Extremity/Cervical Plexus/Brachial Plexus Motor Nerves
1. Axillary motor nerve to the deltoid
2. Long thoracic motor nerve to the serratus anterior
3. Median nerve
1. Median motor nerve to the abductor pollicis brevis
2. Median motor nerve, anterior interosseou branch, to the flexor pollicis longus
3. Median motor nerve, anterior interosseous branch, to the pronator quadratus
4. Median motor nerve to the first lumbrical
5. Median motor nerve to the second lumbrical
4. Musculocutaneous motor nerve to the biceps brachii
5. Radial nerve
1. Radial motor nerve to the extensor carpi ulnaris
2. Radial motor nerve to the extensor digitorum communis
3. Radial motor nerve to the extensor indicis proprius
4. Radial motor nerve to the brachioradialis
6. Suprascapular nerve
1. Suprascapular motor nerve to the supraspinatus
2. Suprascapular motor nerve to the infraspinatus
7. Thoracodorsal motor nerve to the latissimus dorsi
8. Ulnar nerve
1. Ulnar motor nerve to the abductor digiti minimi
2. Ulnar motor nerve to the palmar interosseous
3. Ulnar motor nerve to the first dorsal interosseous
4. Ulnar motor nerve to the flexor carpi ulnaris
9. Other
2. Lower Extremity Motor Nerves
1. Femoral motor nerve to the quadriceps
1. Femoral motor nerve to vastus medialis
2. Femoral motor nerve to vastus lateralis
3. Femoral motor nerve to vastus intermedialis
4. Femoral motor nerve to rectus femoris.
2. Iloinguinal motor nerve
3. Peroneal nerve
1. Peroneal motor nerve to the extensor digitorum brevis
2. Peroneal motor nerve to the peroneus brevis
3. Peroneal motor nerve to the peroneus longus
4. Peroneal motor nerve to the tibialis anterior
4. Plantar motor nerve
5. Sciatic nerve
6. Tibial nerve
1. Tibial motor nerve, inferior calcaneal branch, to the abductor digiti minimi
2. Tibial motor nerve, medial plantar branch, to the abductor hallucis
3. Tibial motor nerve, lateral plantar branch, to the flexor digiti minimi brevis
7. Other
3. Cranial Nerves and Trunk
1. Cranial nerve VII (facial motor nerve)
1. Facial nerve to the frontalis
2. Facial nerve to the nasalis
3. Facial nerve to the orbicularis oculi
4. Facial nerve to the orbicularis oris
2. Cranial nerve XI (spinal accessory motor nerve)
3. Cranial nerve XII (hypoglossal motor nerve)
4. Intercostal motor nerve
5. Phrenic motor nerve to the diaphragm
6. Recurrent laryngeal nerve
7. Other
4. Nerve Roots
1. Cervical nerve root stimulation
1. Cervical level 5 (C5)
2. Cervical level 6 (C6)
3. Cervical level 7 (C7)
4. Cervical level 8 (C8)
2. Thoracic nerve root stimulation
1. Thoracic level 1 (T1)
2. Thoracic level 2 (T2)
3. Thoracic level 3 (T3)
4. Thoracic level 4 (T4)
5. Thoracic level 5 (T5)
6. Thoracic level 6 (T6)
7. Thoracic level 7 (T7)
8. Thoracic level 8 (T8)
9. Thoracic level 9 (T9)
10. Thoracic level 10 (T10)
11. Thoracic level 11 (T11)
12. Thoracic level 12 (T12)
3. Lumbar nerve root stimulation
1. Lumbar level 1 (L1)
2. Lumbar level 2 (L2)
3. Lumbar level 3 (L3)
4. Lumbar level 4 (L4)
5. Lumbar level 5 (L5)
4. Sacral nerve root stimulation
1. Sacral level 1 (S1)
2. Sacral level 2 (S2)
3. Sacral level 3 (S3)
4. Sacral level 4 (S4)

Code 95904 involves the following nerves:

1. Upper Extremity Sensory and Mixed Nerves
1. Lateral antebrachial cutaneous sensory nerve
2. Medial antebrachial cutaneous sensory nerve
3. Medial brachial cutaneous sensory nerve
4. Median nerve
1. Median sensory nerve to the 1st digit
2. Median sensory nerve to the 2nd digit
3. Median sensory nerve to the 3rd digit
4. Median sensory nerve to the 4th digit
5. Median palmar cutaneous sensory nerve
6. Median palmar mixed nerve
5. Posterior antebrachial cutaneous sensory nerve
6. Radial sensory nerve
1. Radial sensory nerve to the base of the thumb
2. Radial sensory nerve to digit 1
7. Ulnar nerve
1. Ulnar dorsal cutaneous sensory nerve
2. Ulnar sensory nerve to the 4th digit
3. Ulnar sensory nerve to the 5th digit
4. Ulnar palmar mixed nerve
8. Intercostal sensory nerve
9. Other
2. Lower Extremity Sensory and Mixed Nerves
1. Lateral femoral cutaneous sensory nerve
2. Medial calcaneal sensory nerve
3. Medial femoral cutaneous sensory nerve
4. Peroneal nerve
1. Deep peroneal sensory nerve
2. Superficial peroneal sensory nerve, medial dorsal cutaneous branch
3. Superficial peroneal sensory nerve, intermediate dorsal cutaneous branch
5. Posterior femoral cutaneous sensory nerve
6. Saphenous nerve
1. Saphenous sensory nerve (distal technique)
2. Saphenous sensory nerve (proximal technique)
7. Sural nerve
1. Sural sensory nerve, lateral dorsal cutaneous branch
2. Sural sensory nerve
8. Tibial sensory nerve (digital nerve to toe 1)
9. Tibial sensory nerve (medial plantar nerve)
10. Tibial sensory nerve (lateral plantar nerve)
11. Other
3. Head and Trunk Sensory Nerves
1. Dorsal nerve of the penis
2. Greater auricular nerve
3. Opthalmic branch of the trigeminal nerve
4. Pudendul sensory nerve
5. Suprascapular sensory nerves
6. Other

*This list has also been published in the American Medical Association’s (AMA) newsletter CPT Assistant April 2003 issue (Volume 13, Issue4). This volume of the CPT Assistant can be purchased from the AMA by going to https://webstore.ama-assn.org/#2. Click on CPT Assistant Back Issues, search by Date, choose 2003 Issues and choose Apr 2003.