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Neurology & Pain Management Coding Alert

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95903, 95900-59? Verify Distinct Nerve

Published on Thu Nov 19, 2009

Question: We billed 95900 and 95903 for a motor nerve conduction study and an F-wave study of the right median nerve. Medicare denied the claim. Should I refile the claim with a modifier? Illinois Subscriber Answer: Because the neurologist performed the motor NCS and F-wave study on only a single nerve -- the right median nerve, you should bill only 95903 (Nerve conduction, amplitude and latency/velocity study, each nerve; motor, with F-wave study). CPT specifies that 95900 (Nerve conduction, amplitude and latency/velocity study, each nerve; motor, without F-wave study), 95903, and 95904 (Nerve conduction ... sensory) should be reported only once even if multiple sites are stimulated or recorded as long as they are on the same nerve. Reporting both CPT codes and appending a modifier to bypass theCorrect Coding Initiative (CCI) edit would be noncompliant coding. Medicare's CCI edits bundle 95900 as a column 2 code or component of [...]
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