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Neurology & Pain Management Coding Alert

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Should We Append -52 to 95860?

Published on Sun Aug 22, 2004

Question: When we report EMG code 95860 without testing the paraspinals, should we attach modifier -52 or reduce our fee?

Wyoming Subscriber

Answer: No, you should not append modifier -52 (Reduced services) to 95860 (Needle electro-myography; one extremity with or without related paraspinal areas) or reduce your fee if the physician does not test the patient's related paraspinal areas.
 
The code descriptor for 95860 clearly states "with or without related paraspinal areas," so you should report this code with no modifiers appended, even if the neurologist does not address the paraspinal areas.
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