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Neurology & Pain Management Coding Alert

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Double Nerve Study Requires Modifier

Published on Mon Oct 04, 2010

Question: I'm new to nerve conduction studies. We are billing 95900 in conjunction with 95903 because they were on different nerves. I'm receiving rejections as these are components of one another. How can I obtainreimbursement for this? California Subscriber Answer: You would need to notify the payer that you aren't trying to "double bill" for the diagnostic motor nerve study by appending modifier 59 (Distinct procedural service) to 95900, to indicate that the diagnostic studies were truly separate. Reason: The Correct Coding Initiative (CCI) considers 95900 (Nerve conduction, amplitude and latency/velocity study, each nerve; motor, without Fwave study) a component of 95903 (... motor, with Fwave study). You can bypass this bundling edit with a modifier provided the diagnostic tests were performed on different nerves.
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