Neurology & Pain Management Coding Alert

Consider modifier 59 a last resort, not your first option
 
Suppose your neurologist diagnoses a patient with carpal tunnel syndrome (354.0) and then performs a needle electromyography (95860, Needle electromyography; one extremity with or without related paraspinal areas) on the same day. You want to report the exam separately, so you append modifier 59 (Distinct procedural service) and hope for the best, right?
 
Wrong. You should append modifier 25 (Significant, separately identifiable E/M service by the same physician on the same day of the procedure or other service) to the E/M code (e.g., established patient visit, 99214). Use this handy tool to decipher which modifier to select while avoiding unnecessary slip-ups -- and submit clean claims every time.