Neurology & Pain Management Coding Alert

Question: I coded my neurologist's diagnostic testing recently that included nerve conduction studies, an EMG, plus H-reflex testing. The neurologist's final diagnosis was S1 radiculopathy (723.4). I billed all of the appropriate codes, plus an E/M code with modifier 25 in the following sequence:99213-2595903-LT x 295903-RT x 295904-LT95904-RT95934-LT95934-RT95861.The patient's carrier (Medicare) denied a lot of the diagnostic studies. Why didn't we get paid for the full services provided? New Jersey Subscriber Answer: When your neurologist performs a nerve conduction study (NCS) and you code 95903 (Nerve conduction, amplitude and latency/velocity study, each nerve; motor, with F-wave study) or 95904 (... sensory) test, you need to code per nerve or nerve branch, not per unilateral limb. Even though your neurologist may have tested identically named nerves on both lower extremities, you don't need to indicate LT (Left side) and RT (Right side) with these codes. In fact, many payers will not [...]