Neurology & Pain Management Coding Alert

Payers are more likely to reimburse 95900, 95903 and 95904 with EMG use Nerve conduction studies (NCS) are becoming a problem for neurology coders looking for reimbursement. Carriers are denying many claims, citing "not medically necessary," "not proven to be effective," or "experimental and investigational" reasons. But don't give up. Here's how your neurologist can get the reimbursement he's due. Reclaim NCS from PCPs As technology continues to improve, many non-neurologists -- including primary care physicians (PCPs) -- are using testing machines and coding their use as nerve tests. This practice has raised red flags with many payers, including Blue Cross/Blue Shield (BCBS), United Health Care (UHC) and Medicare, making neurology reimbursement harder to obtain. Watch out: "The problem we have had is that these doctors do their -neurological testing- on the patient, bill and collect for same, and then, if there is a neuro problem, want to send the patients to [...]