Nerve Conduction Studies

Am unsure how to bill the nerve conduction studies/emg.
95904 - is it billed by multiple lines or 95904 and the quantity allowed?
95900 with a modifier 59?
95903 - multiple lines or 95903 and quantity allowed?

nerve conduction

This should help:
http://www.wpsmedicare.com/part_b/policy/neuro005_billing.pdf

re: nerve conduction

[This should help:
http://www.wpsmedicare.com/part_b/policy/neuro005_billing.pdf]

re: nerve conduction

Could not get this site to pull up. Below.

re: Nerve Conduction Studies

This is from CMS here is the link to view in its entirety, here is the link

http://downloads.cms.gov/medicare-coverage-database/lcd_attachments/31346_6/L31346_NEURO005_CBG_010112.pdfCPT® Codes 95900, 95903, 95904 - Nerve Conduction Studies

1. The CPT® codes 95900, 95903, and/or 95904 are used only once when multiple sites on the same nerve are stimulated or recorded.

2. To qualify as a study of two or more branches of a given motor, sensory, or mixed nerve, both the stimulating and recording electrodes must be moved to different locations; in which case, it is appropriate to bill for the number of multiple units of CPT® codes 95900-95904 performed.

3. Most nerves have a contralateral counterpart; bilateral testing is often necessary for comparison purposes. Nerves on each side may be billed separately. In addition, motor CPT® code 95900 or 95903, sensory CPT® code 95904, and mixed sensory CPT® code 95904 studies on an individual nerve are appropriately carried out and billed separately.

4. CPT® codes 95903 and 95900 may appropriately be billed together for the same patient on the same day when multiple nerves are tested, some with and some without F waves, since, in that case they describe distinct and independent services. However, CPT® codes 95903 and 95900 cannot be billed together for the same nerve in a given patient on a given day.

5. Testing the ulnar nerve at wrist, forearm, below elbow, above elbow, axilla and supraclavicular regions will all be considered as a one-unit test of 95900 or 95904. Different methods of measuring the conduction in the same nerve will not be reimbursed as separate services.

Here are some things I reviewed with my team earlier this year copied and pasted from http://www.aanem.org/About-Us/News/How-to-Deal-with-EMG-Claims-Denials.aspx

CPT® code changes in 2012 resulted in three new codes that are to be used when needle EMGs are performed on the same date of service as nerve conduction studies (NCS). The new codes are:

95885 LIMITED needle EMG of extremity, done same day as NCS
95886 COMPLETE needle EMG of extremity, done same day as NCS
95887 Non-extremity needle EMG, done same day as NCS

1. Did you perform NCS and EMG together and report one or more of the new EMG codes?

If the answer is no, resubmit the claim using the new codes.
If the answer is yes, read on.

2.Are the denials you are receiving for services provided in the first 20 days of the year?

If yes, contact the payer. Many payers did not have the new EMG codes loaded into their claims processing software on January 1st. A complete listing of the CPT® code changes in 2012 can be found in appendix B of the CPT® code book. You may need to send a copy of this list with your request for review.

If the answer is no, read on.

3. Are the denials stating the units of service are incorrect?
Yes – Advise the payer that codes 95885 and 95886 can be billed per extremity tested. If you tested two extremities, you will bill two units. Also advise the payer that these codes are excluded from the Medically Unlikely Edits (MUE’s) developed by the Centers for Medicare and Medicaid Services (CMS).

If the answer is no, read on.
4. Are the denials stating a modifier is necessary?

Yes – Double check which CPT® code is being flagged as needing a modifier. When 95885 and 95886 are billed together, some payers will want the modifier -59 attached to 95885. Some payers may also want to see modifier -59 on nerve conduction code 95900 if it is billed with 95903.

If you billed 95860-95864 instead of 95886, or 95870 instead of 95885, you will need to resubmit the claim with the correct EMG code and units of services for an EMG performed the same day as NCS.