You Be The Coder:
Include E/M with EMG
Published on Tue Nov 03, 2009
Question: A patient came in for a neuro consultation regarding a history of extremity paresthesia but now also has muscle weakness. The neurologist decided that neuromuscular diagnostic studies (i.e., EMG and NCS) were necessary and performed the diagnostic studies to establish the diagnosis. Besides billing for the EMG and NCS diagnostic studies, can we also code for an E/M service in this situation? Wisconsin Subscriber Answer: Although the CPT codes for EMG and NCS tests typically include performance of a brief history and physical exam, if a physician performs and documents additional work that is not only beyond (separately identifiable) and significant from the prediagnostic study and post-diagnostic study work, then it would be appropriate to also report the appropriate E/M code (99241-99255). "Neurologic services are typically consultative, and any of the levels of consultation may be appropriate," according to the AMA CPT Neurology and Neuromuscular Procedures section guidelines. "In [...]
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