Pain Management Coding Alert
Motor/NCS Test Combos
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Question: An established patient reports to the PM physician for a nerve conduction study (NCS). The physician performed motor and nerve function tests for the patient. Notes indicate that in addition to the motor function tests, the PM physician also ran 11 motor function tests. I reported 95905 and 95912 and received a denial. How should I resubmit the claim?
North Dakota Subscriber
Answer: You should resubmit the claim with a single CPT® code. On the claim, report 95905 (Motor and/or sensory nerve conduction, using preconfigured electrode array[s], amplitude and latency/velocity study, each limb, includes F-wave study when performed, with interpretation and report).
Explanation: The 95905 code covers both tests: nerve and motor. Per CPT®: “Do not report 95905 in conjunction with 95885, 95886, 95907-95913.” If the PM physician had only performed 11 nerve studies, then you would have coded 95912 (Nerve conduction studies; 11-12 studies) for the encounterinstead.
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