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Neurology & Pain Management Coding Alert

You Be the Coder:

F-Wave Without NCS

Published on Thu Jan 01, 2004

Question: How should I report F-wave study only? The physician did not perform nerve conduction velocity.

Nevada Subscriber

Answer: CPT no longer contains a code for F-wave study only, having eliminated 95935 (which described H- or F- reflex study by electrodiagnostic testing) in 1996.
 
You have two choices to report F-wave study only: Use unlisted-procedure code 95999 (Unlisted neurological or neuromuscular diagnostic procedure) or 95903 (Nerve conduction, amplitude and latency/velocity study, each nerve; motor, with F-wave study) and append modifier -52 (Reduced services). In each case, you should include documentation with the claim, explaining the exact nature of the test.
 
Neurologists rarely perform F-wave study alone, and payers are likely to be skeptical of the medical necessity of such testing. To better your chances for reimbursement, include a brief note explaining the medical justification for providing the F-wave study without an accompanying nerve conduction study.
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