Physical Therapists: Rules For Nerve Conduction And Needle Electromyographic (EMG) Codes

February 1st, 2018 - Find-A-Code
Categories:   Physical Medicine|Physical Therapy   Billing   CPT® Coding  
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According to Noridian L35081, nerve conduction code 95905 does not have levels of supervision 21, 22, 6a, 66, 77 or 7a assigned to it and is therefore not allowed by Physical Therapists. 

Nerve conduction codes 95907-95913 had their Physician Supervision of Diagnostic Tests Indicators adjusted to 7A effective 01/01/2013 (CR 8169). Therefore, if authorized by state law, Physical Therapists (PTs) with ABPTS certification are allowed to perform the test. In addition, the PT with ABPTS certification may supervise another PT, but only the PT with ABPTS certification may bill.

Needle electromyographic (EMG) codes 95860-95872 and 95885-95887 have the Physician Supervision of Diagnostic Tests indicator of 6A or 66. Therefore, if authorized by state law, Physical Therapists that are certified by the ABPTS are allowed to perform the test without supervision. In addition, the PT with ABPTS certification may supervise another PT, but only the PT with ABPTS certification may bill.

  • 95860 1 extremity with or without related paraspinal areas
  • 95861 2 extremities with or without related paraspinal areas
  • 95863 3 extremities with or without related paraspinal areas
  • 95864 4 extremities with or without related paraspinal areas
  • 95865 larynx
  • 95866 hemidiaphragm
  • 95867 cranial nerve supplied muscle(s), unilateral
  • 95868 cranial nerve supplied muscles, bilateral
  • 95869 thoracic paraspinal muscles (excluding T1 or T12)
  • 95870 limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters
  • 95872 using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied
  • 95885 each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (List separately in addition to code for primary procedure)
  • 95886 each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to code for primary procedure)
  • 95887 non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (List separately in addition to code for primary procedure)

Note: Please refer to your Local Coverage. Ref Article A54095 for additional information regarding supervision levels.

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