Eli's Rehab Report
Break Multiple NCSs Onto Line Items
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Question: When we perform nerve conduction studies (NCSs) on multiple units/nerves bilaterally, can we report both sides? Should we append modifier -76 or modifier -59? We performed bilateral motor testing on the median, ulnar and tibial nerves, totaling six units of 95900. Answer: According to the local medical review policy for Noridian Administrative Services LLC, a Part B carrier in 11 states including Oregon, "When bilateral testing is medically necessary for comparison purposes, the nerve on each side may be billed separately." Most coding consultants recommend reporting three units on each line item as follows, although carriers differ in their preferences for reporting 95900 (Nerve conduction, amplitude and latency/velocity study, each nerve; motor, without F-wave study): A carrier rarely requests that a physiatrist append modifier -76 (Repeat procedure by same physician) to 95900. In addition, most carriers prefer the -LT and -RT modifiers over modifier -50 (Bilateral procedure), while some payers request that you list 95900-59 (Distinct procedural service) x 6 units. Check with your payer to determine how you should report these bilateral procedures to garner the fastest reimbursement.
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Eli's Rehab Report
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