Eli's Rehab Report
Query for Neuromuscular Junction Testing
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Question: I have a physician asking about doing a repetitive study using an EMG machine, but he says it is not an EMG or nerve conduction study. He says it a repetitive study. How should I code this?
New York Subscriber
Answer: Check with your provider if your physiatrist performed neuromuscular junction testing (NMJ). If so, you'd report CPT 95937 (Neuromuscular junction testing [repetitive stimulation, paired stimuli], each nerve, any one method). Physiatrists most often use NMJ to diagnose myasthenia gravis (358.0x).
Proper diagnostic technique often requires testing of two distinct nerves/muscles. Therefore, you'll typically report two units of service. However, if the physiatrist tests a single nerve before and after exercise, you should only report one unit of service per nerve and not the number of times tested during one study.
If the physiatrist performed this procedure in an inpatient hospital setting, you'll report modifier -26 (Professional component) while the facility will report modifier -TC (Technical component).
Your physiatrist's documentation should include characteristics of the test, site(s)/nerve(s) tested, rate of repetition of stimulations, and any significant incremental or decremental response for each nerve he tested.
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