Wiki EMG/NCV-Pain Management

[shanitra]

When coding an EMG/NCV is CPT code 95900 considered an inclusive code with 95903 and 95904? If these two codes are used is it appropriate to not use 95900? If these codes are used will you use mod-59 on every single code?

Thanks

 

[6972juniper]

ncv billing

i have been billing our NCV's in the following way and would like to know if this is correct. the sample below is what i have billed on one patient doing both upper and lower in the same day as well as tibial

95903 x 6 for upper
95904 x 6
95903 x 4 for lower
95904 x 4
95934 50

please let me know if this is correct

 

[LilMissCoder]

95900 is bundled into 95903 only, not 95904. The only way to code it correctly is to have the actual test in front of you. If four nerves were tested with F waves (95903) and the same four were tested without F waves (95900) then you would only bill for the 95903. However, if two nerves were tested with F waves (95903) and two (or however many) different nerves were tested without F waves (95900) then you could bill for both, appending a 59 to the 95900. The key is that it has to be completely different nerves from the ones tested with F waves. I hope that makes sense to you....its so much easier to show with an actual test in front of you.

 

[Maureen]

Your EMG code will state if upper and lower extremities are done, so when I post the NCVs I post the total number of nerves tested, ie 95864 (four extremities) then 95903 x number of nerves tested, same with 95904. There's a limit on the number you can submit, however, depending on diagnosis. I also bill 95900 w/59 modifier.