Eli's Rehab Report

Published on Mon Nov 14, 2005 PDF

Question: How should I report multiple units of nerve conduction studies (NCS)? What about reporting RLE or RUE?


Pennsylvania Subscriber

Answer: Most payers will accept using single line items with the units field indicating the number of units you intend to bill. For example, many payers would find the following acceptable and processable:

• 95903 x 5 (Nerve conduction, amplitude and latency/velocity study, each nerve; motor, with F-wave study)

• 95904 x 3 (...sensory).

On the other hand, some payers limit the number of NCS that they will usually allow at one diagnostic setting without documentation for medical necessity.
 
Unfortunately, you won't find a modifier that specifically addresses right lower extremity (RLE) or right upper extremity (RUE). You may need to use modifier 59 (Distinct procedural service) to indicate that the additional levels are separate and distinct and not merely multiple tests performed on the same nerve.
 
Note: Check with your Medicare carrier to determine if it has a preference for modifier 76 (Repeat procedure by same physician) rather than modifier 59.