EMG Billing

[taran]

I cannot get Medicare to pay for two limited EMG studies (95870X2) on the same date. They will pay full EMG studies for up to four limbs (95860,95861,95863,95864), but they keep stating that it is not payable. I don't want to have my doc's unnecessary stick people more than five times if it is not warrented anyone else having this problem?

 

[dnostdahl]

Emg

It could be your diagnosis code

 

[dmaec]

or, maybe you need a modifier - like 59 or 76 why was it done twice ? repeat same extremity? second time different extremity?

 

[taran]

Different extremity. I've tried the 59 mod, and still get denied. It's frustrating when billing full extremity EMG's other codes are offered but not for the limited studies.

 

[cheermom68]

Emg

Have you tried billing it with a RT and LT? Generally I have found that x2 will get denied but if you identify that it is two different sides they will pay.

 

[taran]

Tried that as well...Medicare has paid you?

 

[nbluvette]

Be sure you are using 95870 for muscles other than thoracic paraspinal (95869) paraspinal, cranial nerve supplied muscles..........
If it is two extremities, identify by LT or RT or RT, RT and the modifier -59 - may need that combination.