TiffianyEdwards
Networker
I am a new coder and I just got assigned to neuro, and I thought I understood the new coding guidelines but am really not sure, so can someone look at this procedure note and tell me what I am seeing or not getting and break it down for me like really barney style.
I see muscle EMG studies that part I get but how do you know if they are the 95885 limited or complete? And I am counting 11 NC studies. The provider submitted 95911 and 95885 x 2 ? I am so lost and confused and the more I do the more I just don't get it.
Motor Nerve Conduction:
Nerve and Site Latency Amplitude Segment Latency
Difference Distance Conduction
Velocity
1. Median.L
A. Wrist 3.8 ms 10.0 mV APB-Wrist 3.8 ms 80 mm m/s
B. Median Elbow Stim 9.0 ms 1.4 mV Wrist-Elbow 5.2 ms 235 mm 45 m/s
C. Ulnar Elbow Stim 10.7 ms 8.7 mV Elbow-Ulnar@elbow 1.7 ms 270 mm
2. Ulnar.L
A. Wrist 4.2 ms 7.0 mV ADM-Wrist 4.2 ms 80 mm m/s
B. Below elbow 7.8 ms 6.0 mV Wrist-Below elbow 3.6 ms 190 mm 53 m/s
C. Above elbow 9.8 ms 5.2 mV Below elbow-Above elbow 2.0 ms 110 mm 55 m/s
3. Peroneal.L
A. Ankle 3.7 ms 2.5 mV EDB-Ankle 3.7 ms 80 mm m/s
B. Fibular head 11.5 ms 2.2 mV Ankle-Fibular head 7.8 ms 330 mm 42 m/s
C. Popliteal 13.6 ms 2.2 mV Fibular head-Popliteal 2.1 ms 100 mm 48 m/s
4. Tibial.L
A. Ankle 5.6 ms 8.0 mV AH-Ankle 5.6 ms 80 mm m/s
B. Pop fossa 13.8 ms 8.1 mV Ankle-Pop fossa 8.2 ms 420 mm 51 m/s
F-Wave Studies
Nerve M-Latency F-Latency
1.Peroneal.L 13.6 56.3
2.Tibial.L 5.6 55.8
3.Median.L 10.7 37.2
4.Ulnar.L 9.8 33.0
Sensory Nerve Conduction:
Nerve and Site Onset Latency Peak
Latency Amplitude Segment Latency
Difference Distance Conduction
Velocity
1.Median.L
A Wrist 3.6 ms 4.4 ms 19 mV Digit II-Wrist 3.6 ms 140 mm 39 m/s
2. Ulnar.L
A. Wrist 3.3 ms 4.2 ms 11 mV Digit V-Wrist 3.3 ms 140 mm 43 m/s
3. Radial.L
A. Forearm 1.8 ms 2.3 ms 31 mV Digit II-Forearm 1.8 ms 100 mm 54 m/s
4. Sural.L
A. Lower leg 3.4 ms 4.0 ms 13 mV Ankle-Lower leg 3.4 ms 140 mm 41 m/s
5. Superficial peroneal.L
A. Ankle 4.1 ms 4.5 ms 6 mV Dorsum of foot-Ankle 4.1 ms 150 mm 37 m/s
Needle EMG Examination:
Insertional Spontaneous Activity Volitional MUAPs
Muscle Insertional Fibs +Wave Fasc Duration Amplitude Poly Config Recruitment
1. Tibialis anterior.L Normal None None None Normal Normal None Normal Normal
2. Gastrocnemius (Medial head).L Normal None None None Normal Normal None Normal Normal
3. Vastus medialis.L Normal None None None Normal Normal None Normal Normal
4. Deltoid.L Normal None None None Normal Normal None Normal Normal
5. Flexor carpi radialis.L Normal None None None Normal Normal None Normal Normal
6. Triceps brachii.L Normal None None None Normal Normal None Normal Normal
7. First dorsal interroseous.L Normal None None None Normal Normal None Normal Normal
I see muscle EMG studies that part I get but how do you know if they are the 95885 limited or complete? And I am counting 11 NC studies. The provider submitted 95911 and 95885 x 2 ? I am so lost and confused and the more I do the more I just don't get it.
Motor Nerve Conduction:
Nerve and Site Latency Amplitude Segment Latency
Difference Distance Conduction
Velocity
1. Median.L
A. Wrist 3.8 ms 10.0 mV APB-Wrist 3.8 ms 80 mm m/s
B. Median Elbow Stim 9.0 ms 1.4 mV Wrist-Elbow 5.2 ms 235 mm 45 m/s
C. Ulnar Elbow Stim 10.7 ms 8.7 mV Elbow-Ulnar@elbow 1.7 ms 270 mm
2. Ulnar.L
A. Wrist 4.2 ms 7.0 mV ADM-Wrist 4.2 ms 80 mm m/s
B. Below elbow 7.8 ms 6.0 mV Wrist-Below elbow 3.6 ms 190 mm 53 m/s
C. Above elbow 9.8 ms 5.2 mV Below elbow-Above elbow 2.0 ms 110 mm 55 m/s
3. Peroneal.L
A. Ankle 3.7 ms 2.5 mV EDB-Ankle 3.7 ms 80 mm m/s
B. Fibular head 11.5 ms 2.2 mV Ankle-Fibular head 7.8 ms 330 mm 42 m/s
C. Popliteal 13.6 ms 2.2 mV Fibular head-Popliteal 2.1 ms 100 mm 48 m/s
4. Tibial.L
A. Ankle 5.6 ms 8.0 mV AH-Ankle 5.6 ms 80 mm m/s
B. Pop fossa 13.8 ms 8.1 mV Ankle-Pop fossa 8.2 ms 420 mm 51 m/s
F-Wave Studies
Nerve M-Latency F-Latency
1.Peroneal.L 13.6 56.3
2.Tibial.L 5.6 55.8
3.Median.L 10.7 37.2
4.Ulnar.L 9.8 33.0
Sensory Nerve Conduction:
Nerve and Site Onset Latency Peak
Latency Amplitude Segment Latency
Difference Distance Conduction
Velocity
1.Median.L
A Wrist 3.6 ms 4.4 ms 19 mV Digit II-Wrist 3.6 ms 140 mm 39 m/s
2. Ulnar.L
A. Wrist 3.3 ms 4.2 ms 11 mV Digit V-Wrist 3.3 ms 140 mm 43 m/s
3. Radial.L
A. Forearm 1.8 ms 2.3 ms 31 mV Digit II-Forearm 1.8 ms 100 mm 54 m/s
4. Sural.L
A. Lower leg 3.4 ms 4.0 ms 13 mV Ankle-Lower leg 3.4 ms 140 mm 41 m/s
5. Superficial peroneal.L
A. Ankle 4.1 ms 4.5 ms 6 mV Dorsum of foot-Ankle 4.1 ms 150 mm 37 m/s
Needle EMG Examination:
Insertional Spontaneous Activity Volitional MUAPs
Muscle Insertional Fibs +Wave Fasc Duration Amplitude Poly Config Recruitment
1. Tibialis anterior.L Normal None None None Normal Normal None Normal Normal
2. Gastrocnemius (Medial head).L Normal None None None Normal Normal None Normal Normal
3. Vastus medialis.L Normal None None None Normal Normal None Normal Normal
4. Deltoid.L Normal None None None Normal Normal None Normal Normal
5. Flexor carpi radialis.L Normal None None None Normal Normal None Normal Normal
6. Triceps brachii.L Normal None None None Normal Normal None Normal Normal
7. First dorsal interroseous.L Normal None None None Normal Normal None Normal Normal