Neurology & Pain Management Coding Alert

Question: An established patient reports to the neurologist for a nerve conduction study to test for myasthenia gravis (MG). The neurologist performed motor and nerve function tests for the patient, which resulted in a confirmed diagnosis of MG with no exacerbation. Notes indicate that in addition to the motor function tests, the neurologist also ran 11 motor function tests. I reported 95905 and 95912 and received a denial. How should I resubmit the claim?

North Carolina Subscriber

Answer: You should resubmit the claim with a single CPT^® code. On the claim, report 95905 (Motor and/or sensory nerve conduction, using preconfigured electrode array[s], amplitude and latency/velocity study, each limb, includes F-wave study when performed, with interpretation and report) with ICD-10 code G70.00 (Myasthenia gravis) appended to 95905 to represent the patient’s condition.

Explanation: The 95905 code covers both tests: nerve and motor. Per CPT^®: “Do not report 95905 in conjunction with 95885, 95886, 95907-95913.” If the neurologist had only performed 11 nerve studies, then you would have coded 95912 (Nerve conduction studies; 11-12 studies) for the encounter instead.