Eli's Rehab Report

Published on Wed Feb 25, 2004 PDF

Question: In your March 2004 article "Don't Forget EMG Guidance With Myobloc Injections," you listed several EMG codes. Our physiatrist thinks we have to test at least three muscles to report 95860-95864. Is this true? 

Indiana Subscriber

Answer: No. You must test at least five muscles to report the electromyography (EMG) codes 95860-95864, according to AdminaStar Federal's (a Part B carrier in Indiana) local medical review policy. Select the appropriate code from this series based on the number of extremities that the physiatrist tests.

The LMRP states, "To bill for codes 95860-95864, extremity muscles innervated by three nerves (e.g., radial, ulnar, median, tibial, peroneal, femoral, not sub-branches) or four spinal levels must be evaluated; a minimum of five muscles must have been studied."

If you examine fewer than five muscles, you should report 95870 (Needle electromyography; limited study of muscles in one extremity or non-limb [axial] muscles [unilateral or bilateral], other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters). 

-- You Be the Coder and Reader Questions were reviewed by Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, director and senior instructor for the CRN Institute, an online coding certification training center.