Eli's Rehab Report

Published on Wed Apr 06, 2005 PDF

Question: Can I report one unit of CPT 95861 , two units of 95900, and three units of 95904 together? Should I use any modifiers? Should I specify the nerve at each site?

California Subscriber

Answer: Yes, you can bill 95861 (Needle electromyography; two extremities with or without related paraspinal areas), two units of 95900 (Nerve conduction, amplitude and latency/velocity study, each nerve; motor, without F-wave study), and three units of 95904 ( .. .sensory) together, and you don't need to append any modifiers for this code combination. Many payers will use one line item for the motor or sensory nerve conduction study tests and use box 24G to indicate the multiple units. For example, if this is the case, you may report 95900 on 1 line item with "2" in 24G and then report 95904 on a second line with "3" in 24G.

Keep in mind: Most payers will process up to the range of 3 units per NCS code and then have "difficulties" processing larger numbers of units.

Certain payers may request that you use modifiers -RT (Right side) and -LT (Left side) to separate out into 2 line items the number of motor and/or sensory performed on each extremity side. For example, the physician performed a total of 4 motor and 6 sensory NCS (performed equally on both upper extremities). In this case, you may report:

95900-RT 2 units

95900-LT 2 units

95904-RT 3 units

95904-LT 3 units