Eli's Rehab Report

You Be The Coder:

Should We Append -52 to 95860?

Question: When we report EMG code 95860 without testing the paraspinals, should we attach modifier -52 or reduce our fee?

Wyoming Subscriber

Answer: No, you should not append modifier -52 (Reduced services) to CPT 95860 (Needle electromyography; one extremity with or without related paraspinal areas) if the physician does not test the patient's related paraspinal areas.

The code descriptor clearly states "with or without related paraspinal areas," so you should report this code even if the physiatrist does not address the paraspinal areas. Do not reduce your fee if the physician does not test the paraspinals.