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Can someone with experience in Emg coding for Ortho lend me a hand with how to interpret the Attached Emg study? Provider billed 95911 and 95886. Payer denied stating to resubmit with appropriate cpt code.
I would recommend referencing Appendix J of the CPT code book which provides a breakdown of motor and sensory nerves. Based on review of the report, I am counting 4 sensory (median-D1, median-D4, radial-D1, ulnar-D4) + 3 motor (median-APB, ulnar-APB, ulnar-ADM) = 7 studies (95910). On the motor nerves, you would not count the 2nd point stim on the median-APB nor the 2nd and 3rd stims in the ulnar-ADM. Your 95886 is correct.
I would recommend referencing Appendix J of the CPT code book which provides a breakdown of motor and sensory nerves. Based on review of the report, I am counting 4 sensory (median-D1, median-D4, radial-D1, ulnar-D4) + 3 motor (median-APB, ulnar-APB, ulnar-ADM) = 7 studies (95910). On the motor nerves, you would not count the 2nd point stim on the median-APB nor the 2nd and 3rd stims in the ulnar-ADM. Your 95886 is correct.