Wiki EMG Billing Difficulties

[shrewsburyfitk@aol.com]

I'm receiving denials from a few carriers, including Cahaba GBA (TN Medicare) when we bill a limited EMG (95885) on one extremity and a complete EMG on a different extremity
(95886). I am billing 95885 as one line item and 95886-59 for the other. This works great if I'm billing for 2 95886's on separate extremities, but not a combination of 95885 and 95886 - two different extremities.

Can anyone shed some light on why this is happening and what I can do to get this paid?

I appreciate your help.

Debbie

 

[shrewsburyfitk@aol.com]

Good morning! Dropping in to answer my own question just in case anyone has had this problem and might find it helpful.

I did finally get hold of a representative with Medicare who was willing to help. The solution was actually quite simple. Modifier 59 belongs on 95885 when billing 95885 and 95886 for a different extremity. When billing for 95886 for two extremities - bill on two separate lines and append modifer 59 to the SECOND unit of 95886.