Neurology & Pain Management Coding Alert

Question: May I apply modifier -50 to 95900 for bilateral testing of carpal tunnel syndrome (CTS)?

Maryland Subscriber Answer: No, you should not append modifier -50 (Bilateral procedure) to motor nerve conduction study (NCS) test code 95900 (Nerve conduction, amplitude and latency/velocity study, each nerve; motor, without F-wave study). Rather, you should report a separate unit of 95900 for each separate test the neurologist performs.

For example, to report one test on both the left and right upper extremity, you should code 95900 x 2. To differentiate the test locations, however, you may append modifiers -LT (Left side) or -RT (Right side) as appropriate. Be sure to note, however, that you may report only one unit of 95900 for multiple sites on the same nerve (for complete information on reporting NCS, see "4 Steps Will Improve Your NCS Reimbursement," Neurology Coding Alert, April 2004).

Do not append modifier -51 (Multiple procedures) to subsequent codes. Because each code represents an independent procedure (that is, there is no "shared" work between the procedures), multiple-procedure fee reductions do not apply.