Wiki help with NCV and EMG coding

[ksw]

I am getting denials when billing the NCV and EMG together. Can someone tell me the correct way to code this. thanks in advance

 

[boyett]

what codes are you billing together?

 

[mhstrauss]

Yes, please give more info...what codes billed together? What exactly is the denial? Any specific payers? Diagnoses used?

 

[ksw]

i use the 95903- 95913 depending on number of nerves and the 95885...mostly dx are 356.9, 355.5, 354.1...

 

[mhstrauss]

i use the 95903- 95913 depending on number of nerves and the 95885...mostly dx are 356.9, 355.5, 354.1...

What exactly is the denial you are consistently getting?

 

[ksw]

that it isn't a covered service on some and then not allowed to be billed together...i just need to know how others are coding them...Do i use a 59 modifier?

 

[mhstrauss]

that it isn't a covered service on some and then not allowed to be billed together...i just need to know how others are coding them...Do i use a 59 modifier?

If you are billing 1 unit with an NCV code (95907-95913), and 1 unit of an EMG code (95885, 95886), you should not need any modifiers, and per current CPT guidelines, yes, they can be billed together. They are billed together 99% of the time in my clinic. "Not covered"...could be that the diagnosis doesn't support medical necessity per that payer's guidelines or LCD.

 

[ksw]

Thanks