Wiki 95910 confirmation

[jenarnold]

Hi Coders, I am working with a doctor who is questioning the new NCS coding and reimbursement. I have given my opinion, as well as the opinion of my fellow coding peers at work. Despite our professional opinions, he's amicably unconvinced. I'm hoping a few more opinions will help. He has billed 95913 for 13 studies. My opinion is 8 studies.
How many studies would you code? Thank you, thank you for your time! It is greatly appreciated.

Motor Nerve Study
P. tibial Nerve ANKLE site
Latency R-3.9 L-4.2
AMP (mV) R-8.2 L3.1
P. tibial Nerve Knee site
Latency R-13.2 L-12.9
AMP (mV) R-5.0 L-2.0
Conduction Velocity (m/s) motors only R-41.1 L-44.0

Peroneal Nerve ANKLE site
Latency R-4.3 L-3.6
AMP (mV) R-3.7 L-13.2
Peroneal Nerve KNEE site
Latency R-10.9 L-10.5
AMP (mV) R-2.9 L-10.8
Conduction Velocity (m/s)(motors only) R-49.5 L-44.9


Sensory Nerve Study
Sural Nerve
Latency R-2.3 L-2.2
AMP (mV) R-20 L-20


F-Wave Study
P. Tibial Nerve
Latency
R-53.0 L-50.8
Peroneal Nerve
Latency
R-51.0 L-49.4

H-Reflex Sudy
P. Tibial Nerve
Latency
R-29.0 L-31.3

 

[marvelh]

I agree 8 or 95910 x 1
Motor with F wave NCS:
1 & 2 R&L Posterior Tibial nerve (to abductor hallucis) with stimulation at ankle & Knee - most common muscle tested with those stimulation sites to that nerve)
3 & 4 R&L Peroneal nerve (to extensor digitorum brevis) with stimulation at ankle & Knee - most common muscle tested with those stimulation sites to that nerve)

Sensory NCS
5 & 6 R&L Sural nerve

H-Reflex
7 & 8 R&L

Multiple stimulation sites along the same nerve is still counted as 1 study. Likewise Motor with a F wave study is counted as 1 study not two.

I would show the physician the CPT Section Guidelines for Nerve Conduction Studies - "... For the purposes of coding, a single conduction study is defined as a sensory conduction test, a motor conduction test with or without F wave test or an H-reflex test. Each type of study (sensory, motor with or without F wave, H-reflex) for each nerve includes all orthodromic and antidromic impulses associated with that nerve and constitutes as distinct study when determining the number of studies in each grouping (eg, 1-2 or 3-4 nerve conduction studies). Each type of nerve conduction study is counted only once when multiple sites on the same nerve are stimulated or recorded. ..."

 

[nevrolog]

NCS "count"

A good rule of thumb for the doc (I am a neurologist, BTW) is this: If you move the recording electrodes, it's ANOTHER study, if not (as in an F-wave), the count does NOT go up.

 

[OCD_coder]

Thank you nevrolog for visiting our forum and sharing your input, I hope to see more physicians participating as your information is priceless for us to understand the process of your work.