Wiki Medicare

[amobeen]

why medicare does not pay 95900?

 

[hopepg]

What is it being denied for? If not considered medically necessary, check out the Local Coverage Determination for your Medicare contractor.

 

[cmcgarry]

Aso, what other services were billed on the claim? For example, they will deny 95900 if you also billed a 95903; you would then need to check the report to determine if those studies were different nerves, and could use a 59 modifier if so. Also, as the previous responder noted, check your local carrier/MAC for an LCD. One carrier, WPS, has in their LCD that an NCS performed without EMG is screening and therefore not covered.

Hope this helps,

 

[amobeen]

Thank you so much. Only Medicare and Medicaid Denied this 95900. And when I added 59 to it, Medicare paid.Waiting for Medicaid response.

 

[RebeccaWoodward*]

What was your denial? Review your local LCD to see if you have met medical necessity.

http://www.cms.gov/mcd/viewlcd.asp?...G):Carrier:CIGNA+Government+Services+(05535):