Pain Management Coding Alert
Coding Both Parts of EDX Test
PDF
Question: I have a confusing claim in front of me. Encounter notes indicate that the physician performed a 14-part nerve conduction study (NCS) and a limited electromyography (EMG) for the same patient during the same session. The patient was suspected of suffering from traumatic nerve lesions. Is there a single code for this service, or do I need to report multiple codes?
Texas Subscriber
Answer: This service is most likely electrodiagnostic (EDX) testing, which occurs when your provider performs an NCS in combination with an EMG. If the tests occurred during the same encounter, it’s virtually certain that this was an EDX service. If you have any doubt as to whether the physician performed a complete EDX, check with her before filing the claim.
For the NCS, you’d report 95913 (Nerve conduction studies; 13 or more studies). For the EMG, opt for 95885 (Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited [List separately in addition to code for primary procedure]).
Caveat: The 95885 code is an add-on code, and you must report it along with a primary code; in this scenario, the primary code is 95913. You should never, under any circumstances, report 95885 as a primary code.
Pain Management Coding Alert
- CPT® 2017:
CPT® Creates Injection/Guidance Combo Codes
Experts: New codes should augur well for injection/guidance payment. Pain management practices need to know [...] - Modifiers:
Choose Between 59/X After Identifying Distinct Services
Modifier 59 or one of the X modifiers? Choice still payer-dependent. When deciding if the [...] - Clip and Save:
Get HPI Info With This Template
Expert: Direct questions help to get to the heart of HPI details. Once the provider [...] - You Be the Coder:
Coding Both Parts of EDX Test
Question: I have a confusing claim in front of me. Encounter notes indicate that the physician [...] - Reader Question:
ICD-10 Clears Up Zika Dx Question
Question: We don’t typically get patients with Zika virus, but the physician recently treated a pregnant [...] - Reader Question:
Keep These 64447 Edits In Mind When Coding
Question: Our provider uses ultrasound guidance when administering a postoperative nerve block after total knee [...] - Reader Question:
Check for Modifier 51 Opportunities on Injections With Fluoroscopy
Question: Our physician recently performed multiple arthroscopic injections, and the encounter notes look kind of tricky. [...] - Reader Question:
Remember, PHI Takes Many Forms
Question: I’m pretty sure I know what types of information constitute protected health information (PHI). I [...] - Reader Question:
Drop 1-Hour Rule on These Neurostimulator Tests
Question: Our physician recently performed a complex spinal cord neurostimulator test with subsequent programming. Encounter notes [...] - Reader Question:
Consider Taking CPPM® Exam to Expand Skills Scope
Question: I work for a small practice where I do a little bit of everything; coding, [...]