Eli's Rehab Report

Published on Fri Aug 15, 2003 PDF

Question: Can a nonphysician practitioner perform a nerve conduction study, or must the physiatrist personally perform it?

Colorado Subscriber

Answer: Depending on your state guidelines, therapists and certain technicians may be able to perform nerve conduction studies (NCSs) without the physiatrist present in the room.
 
According to the April 19, 2001, Medicare Program Memorandum B-01-28, the following personnel may perform the nerve conduction studies described by codes 95900-95904 and 95933-95937: physical therapists (PTs) certified by the American Board of Physical Therapy  Specialties (ABPTS), PTs directly supervised by physicians, and certified technicians supervised by physicians.
 
Each state carrier may have its own practice regulations that dictate whether PTs and technicians can report NCSs. Noridian Medicare, a Part B carrier in Colorado, maintains a local medical review policy that states, "NCSs must be either: (a) performed directly by a physician, or (b) performed by a trained individual under the direct personal supervision of a physician, or (c) personally performed by a physical therapist certified by the ABPTS as an electrophysiological clinical specialist AND is permitted to provide the service under state law."
 
And Noridian allows a certified PT to personally supervise another PT, but only the certified PT may report the service to Medicare.
 
Insurance auditors look at the quality of care your practice provides, and if a PT who is not trained in electrophysiological studies performs an NCS, the auditor would question how the PT selected the appropriate nerves and would wonder who could troubleshoot if certain nerves couldn't be located. You should therefore ensure that any staff members who perform NCSs are well trained or supervised very closely.