CPT® Code 92265

1. Indications

Needle oculoelectromyography is indicated for the evaluation of various conditions affecting the extraocular muscles and their associated nerve function. The following are specific indications for performing this procedure:

• Myasthenia Gravis - A neuromuscular disorder characterized by weakness and rapid fatigue of voluntary muscles, particularly affecting eye movement.
• Ocular Motility Disorders - Conditions that impair the ability of the eyes to move properly, which may include strabismus or other alignment issues.
• Neuromuscular Junction Disorders - Disorders that affect the communication between nerves and muscles, leading to muscle weakness.
• Other Neuromuscular Conditions - Various other conditions that may impact the function of the extraocular muscles and require assessment of nerve and muscle activity.

2. Procedure

The procedure for needle oculoelectromyography involves several key steps to ensure accurate assessment of the extraocular muscles. The following outlines the procedural steps:

• Step 1: Patient Preparation - The patient is positioned comfortably, and the area around the eyes is cleaned to minimize the risk of infection. The physician explains the procedure to the patient, addressing any concerns and obtaining informed consent.
• Step 2: Electrode Insertion - A fine needle electrode is carefully inserted into the targeted extraocular muscle. This insertion is performed with precision to ensure that the electrode is placed at the nerve-muscle junction, which is critical for accurate readings.
• Step 3: Recording Electrical Activity - Once the electrode is in place, it is connected to a recording device. The physician stimulates the muscle fibers, and the electrical activity generated by the muscle is recorded. This activity is displayed on a visual monitor as waveforms.
• Step 4: Data Interpretation - The physician analyzes the recorded waveforms, assessing the action potentials to evaluate the muscle's response to nerve stimulation. This analysis is crucial for diagnosing any underlying neuromuscular conditions.
• Step 5: Report Generation - After completing the procedure, the physician compiles a detailed report summarizing the findings from the needle EMG. This report includes interpretations of the electrical activity and any relevant observations that may assist in the patient's diagnosis and treatment plan.

3. Post-Procedure

After the needle oculoelectromyography procedure, patients may experience mild discomfort or soreness at the insertion site, which typically resolves quickly. There are generally no significant restrictions on activities following the test, but patients are advised to avoid strenuous activities for a short period. The physician will review the findings with the patient during a follow-up appointment, discussing any necessary next steps based on the results of the EMG. It is important for patients to report any unusual symptoms or prolonged discomfort following the procedure to their healthcare provider.