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Neurology & Pain Management Coding Alert

Want to Know Which Codes to Report Directly to SNFs? Here They Are

Published on Mon Mar 22, 2004

Medicare includes many services in its consolidated billing requirements: Here are the common neurology services you should be aware of.

For Medicare beneficiaries in a Part A covered stay, you must report the technical component (with modifier -TC appended) of the following services directly to the SNF for reimbursement:

 95860-95870 -- Needle electromyography...
95872 -- Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied
95875 -- Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)
95900-95904 -- Nerve conduction, amplitude and latency/velocity study, each nerve ...
95921-95937 -- Autonomic function tests, evoked potentials and reflex tests. If you treat Medicare beneficiaries in a Part B stay, you must arrange with the SNF to collect payment for the following services. These codes do not split into "technical" and "professional" components, so you should bill the SNF for the global fee.

95831-95834 -- Muscle testing, manual (separate procedure) with report ...
95851-95852 -- Range-of-motion measurements and report (separate procedure) ...
97799 -- Unlisted physical medicine/rehabilitation service or procedure.  For a full list of services that fall under Medicare's consolidated billing requirements, visit the CMS Web site www.cms.gov.
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