Wiki EMG testing 95870

[hanoz420@hotmail.com]

We billed a 95870 with 2 units for a Medicare patient and it was denied as missing/incomplete/invalid days or units of service.

The documentation states:

EMG evaluation of selected left upper extremity muscles, normal.
EMG evaluation of selected right upper extremity muscles, normal.

After further review, less than 3 muscles were tested in the left & right upper extremities.

Are we billing it correctly? It went in w/95870 with 2 units. OR should we be billing it on 2 separate lines, with mod 59 appended to the 2nd 95870?

Can someone help us....please?

Thank you!

 

[tdml97@yahoo.com]

I had the same problem - it goes out like this:

95870-GP
95870-GP-76

 

[hanoz420@hotmail.com]

Thanks for your input I really appreciate it. However in our case, I think the GP mod wouldn't apply. Our Physiatrist performed it in her office and the testing was done on the RT & LT....I know mod 76 is for a repeat procedure performed by same physician, in this case because 2 anatomical sites, maybe mod 59 would be a better code choice?

 

[tdml97@yahoo.com]

Nope - I tried the mod 59 first & it didn't work for Medicare. I bill for PT - done in office.
The GP mod should be on all PT codes when they go out.

 

[hanoz420@hotmail.com]

Ok Thanks!