Reader Question:
Billing for Tests and Interpretations
Published on Mon Nov 01, 1999
Question: If a neurologist performs an EMG/NCN, can he bill for the test and the interpretation, especially 95860/95860-26?
Anonymous Illinois Subscriber
Answer: Code 95860 (needle electromyography, one extremity with or without related paraspinal areas) has both a technical and professional component. When the neurologist owns the equipment, performs the test and writes an interpretation, he or she may bill for the entire (or total component) by using the CPT code without any modifiers.
When the physician interprets a test performed on equipment owned by another facility, such as a hospital, he would bill the professional component only by attaching modifier -26 (professional component) to 95860. The neurologist then would be reimbursed only for that portion of the test. The physician may not bill for the total component and the professional component because the professional component is included in the total component.
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