Wiki Emg/ncv

ksw

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I need some clarification please: if i used to code this way
95861
95900 x4
95904 x4

what codes do I use now? I do not have the new book....and if an fwave is in there how would i code it?
kw
 
Just wait until 2013...they're changing all of the EMG codes again.

See if one of your doctors is a member of the AANEM, and if they are, ask if they would be so kind as to print the info from the 2013 Coding Toolkit. The info is really helpful, explained simply and there's a nice crosswalk. You can see the basic info on the AANEM's website, but the detailed stuff is for members only. RVU changes are available for everyone to view on their site.

AANEM Coding Info: http://www.aanem.org/Practice/Coding.aspx

I can also send you the info from the Toolkit if you'd like! Feel free to email me at taparker7@hotmail.com and I can forward you what I've got.


Tara
 
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still confused

I'm a little confused by the wording of the new codes 95907-95913...i'm reading it as all tests on one nerve are considered one test now. Our doc seems to think that all tests are counted individually even if on same nerve...

"In her case I did 6 different studies, using 3 different nerves"

I would code that as 95908 (3-4 since there are only 3 nerves tested), he says 95909 (5-6 since there were 6 studies done)

Any advice?
 
Per CPT 2013 book, a single conduction study is defined as a sensory conduction test, a motor conduction test w or w/o an f-wave or an H-Reflex test. Each type of study for each nerve includes all orthodromic and antidromic impulses associated with that nerve and hence considered distinct study. It also states that each type of conduction study is counted only once when multiple sites on the same nerve are stimulated. So the total number of tests should be added together to get the right code from 95907-95913.
Previously, coding was based on each nerve involved in testing.

I think now the confusion should not be there since the new codes only says nerve conduction test and differentiation whether they are motor or sensory test is no longer there.

Hope this helps.

NidhiM, CPC
www.symbiosisbilling.com
 
appealing medicare

need help too here.. i am aware of the new emg codes for 2013... im appealing a claim for dec 2012, which goes as:
95204 which got paid
95900 x2 -59
95903 x4 -59
95904 x8 -59
95886-59 which got paid.
how should i correct this? im aware that 95907-95913 is for 2013.
 
need help also with emg/nct

I am also having trouble with the coding of emg/nct studies.
the cpt book states when you do emg studies with nct studies you use the add on codes
95885,95886, or 95887. so we have been coding like this
95860, 95885, 95908. Some ins companies are paying for the add on codes with
the nct studies and not paying for the emg code 95860. I am I correct that you can not
use add on codes as the primary code? I am really getting discourage about this. I really
could use some other opinions on this
Thanks
Debbie with Neurology
 
The two code sets for EMGs should not be billed together, i.e. 95860 should not be billed with 95885 or 95886. They are either / or codes

If physician performs EMG without nerve conduction studies then code from 95860-95864

IF physician performs EMG AND nerve conduction studies, then use codes 95885 and 95886 to report the limb EMG studies.
 
need help too here.. i am aware of the new emg codes for 2013... im appealing a claim for dec 2012, which goes as:
95204 which got paid
95900 x2 -59
95903 x4 -59
95904 x8 -59
95886-59 which got paid.
how should i correct this? im aware that 95907-95913 is for 2013.

you could try reporting each ncs study at 1 unit: 95900, 95900-59, 95903, 95903-59, 95903-59, 95903-59 etc...

I recall Mcare paying when reported on seperate lines in 2012
 
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NCT units -neurology

Hi,
Can you please help me with 95907-95913 codes? I understand that there are no more units to be used with these codes and they pay so little now. Am I correct regarding the units?
Please advise.
Thanks a lot.
Lucy
 
Hi,
Can you please help me with 95907-95913 codes? I understand that there are no more units to be used with these codes and they pay so little now. Am I correct regarding the units?
Please advise.
Thanks a lot.
Lucy

Yes, you are correct; you no longer add multiple units to the NCV codes. The number of units is indicated by whichever code is selected. There was a big drop in reimbursement; I believe the AAN and probably the AANEM are trying to work with the RUC to raise the RVU's for these codes, but that hasn't happened yet.

Hope this helps!
 
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