Wiki 2013 Nerve Conduction Study Codes - Can anyone provide

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wilsontheresa@optonline.net

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Can anyone provide some guidance in billling these new codes? I see that some carriers are indicating that they pay these codes per unit. My understanding of code 95911 is that it includes up to 10 studies. Does this code get billed in units or not? Any help will be much appreciated. thank you!
 
95911 covers 9 or 10 studies, which reflects the total number of studies, whether motor, w/ f-wave, sensory, and/or h-reflex. Simply count the number of studies to arrive to the correct code. 95913 is the max. It covers 13 studies or more, even if it's 100...

These codes are limited to a unit of 1. Bill only one of the NCS codes once at a maximum of one unit per claim. Any EMG studies would be an add-on code.
 
Also, Appendix J in the 2013 CPT manual is all about electrodiagnostic testing and may help when it comes to counting nerves/tests (page 652 in the AMA version).
 
yeah these can only be billed one unit per day. I would also add that the f-wave tests should not be counted separately, per the guidelines at the beginning of that section.
 
Counting nerves?

I've been counting nerves: medial, Ulnar, Tibial, etc. and not segments of nerves. I count Motor/F as one study and sensory as one study, so a total of 2 studies per nerve, per side.

Is that what anyone else is doing too? Or are you counting nerve segments?
Does anyone have official guidance on this?

TIA
 
That's correct, segmental testing is still not billable. NCS is counted per nerve, mulitiple sites on the same nerve may not be counted separately. This is still in the NCS guidelines in CPT I believe. Yes the motor/f wave counts as one because the f is not counted separately, and the sense counts as one. Also dont forget if you did any h-reflex testing (used to be 95934 and 95936), those would be counted as well.
 
Can someone clarify one more thing in regards to reporting nerve conduction studies....if motor conduction testing is performed on the Right & Left Median Nerve AND sensory conduction testing is also performed on the Right & Left Median Nerve...would this be counted as 4 nerve conduction studies (motor x2 & sensory x2) OR do you count only the NERVE tested & therefore it would be counted as only 2 nerve conduction studies (RT & LT Median Nerve = 2)? I think it's the prior, but I'm starting to confuse myself. I understand that we don't count F waves & we don't count multiple sites on the same nerve. Thanks so much!!
 
mkmgt001 said:
Can someone clarify one more thing in regards to reporting nerve conduction studies....if motor conduction testing is performed on the Right & Left Median Nerve AND sensory conduction testing is also performed on the Right & Left Median Nerve...would this be counted as 4 nerve conduction studies (motor x2 & sensory x2) OR do you count only the NERVE tested & therefore it would be counted as only 2 nerve conduction studies (RT & LT Median Nerve = 2)? I think it's the prior, but I'm starting to confuse myself. I understand that we don't count F waves & we don't count multiple sites on the same nerve. Thanks so much!!
Click to expand...


This test is counted as 4 units. You can count motor AND sensory for each nerve tested, with the exceptions you listed above regarding F wave and multiple sites. So in your example; Right Median, motor test; Left Median, motor test; Right Median, sensory test; Left Median, sensory test = 4 units = 95908.
You're on the right track! :D
 
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