NCV/EMG Question

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Hi,

I'm new to coding and I have a question regarding Coding and billing of NCV/EMG.

I just received an invoice with multiple charges for Left Lower and Right Lower NCV/EMG using the the following Codes: 95913, 95885.

For Example:
NCV/EMG Left Lower: 95913, 95885
NCV/EMG Right Lower: 95913, 95885
NCV/EMG Left Upper: 95913, 95885
NCV/EMG Right Upper: 95913, 95885

After researching and reviewing the CPT manual and looking through the web--I can't find anything relating to coding or billing Left or Right lower/upper when coding NCV/EMG. After reading the CPT manual--it seems that your options are 13+ muscles: use Code 95913.

Can anyone provide me with some clarification and insight.

Thank you,

Ingrid:confused:
 

mhstrauss

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Baton Rouge
Best answers
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Hi,

I'm new to coding and I have a question regarding Coding and billing of NCV/EMG.

I just received an invoice with multiple charges for Left Lower and Right Lower NCV/EMG using the the following Codes: 95913, 95885.

For Example:
NCV/EMG Left Lower: 95913, 95885
NCV/EMG Right Lower: 95913, 95885
NCV/EMG Left Upper: 95913, 95885
NCV/EMG Right Upper: 95913, 95885

After researching and reviewing the CPT manual and looking through the web--I can't find anything relating to coding or billing Left or Right lower/upper when coding NCV/EMG. After reading the CPT manual--it seems that your options are 13+ muscles: use Code 95913.

Can anyone provide me with some clarification and insight.

Thank you,

Ingrid:confused:

The charges for the NCV above are incorrect. 1 code should be billed for a total of all NCS's for that DOS. Clinically, I find it highly unlikely that THAT MANY studies would be done on 1 limb at one time anyway! With 15 Neurologists and Physiatrists in my clinic, we perform quite of few of these tests, and the majority of ours don't even get up to a 95913 with all limbs total. You are correct, based on CPT instruction--should use 95913 x 1.

The EMG billed as above could be appropriate, based on CPT guidelines.

HTH!
 

knbiggs

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Denials

I was wondering if someone could email me that knows a lot about emg billing. We are physiatrists here and do a lot of emg's. We have been fine except for this past year. We are getting a lot of medicare denials. We thought we had it down and I even did some appeals that got approved.
We bill like a bilateral:
95886 X2 with modifier KX
95910 with modifier XE & KX
both with the model number of machine

IF we bill for like a single and a bilateral only the bilateral gets paid:
95886 X2
95885
95910

I am trying to get down the X modifers down.. does the 95885 need an XS? i just saw that as an option.

my email is kendra.ossr@yahoo.com if anyone is willing to help or knows anything helpful!
Kendra
Neuroscience Specialists, PC
Oklahoma City
 
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