nerve conduction studies-I wanted to ask

[aruiz1231@yahoo.com]

Hello I wanted to ask some advice on some procedure codes that keep getting denied for payment is there a certain way to appeal these or a certain way to code them together? they are 95886-59, 95903 and 95904 please!!!

 

[pajohnson]

If you are billing EMG/NCS code for 2013 you have to use the 95907-95913, along with the 95886. Hope this helps

 

[mitchellde]

Yes 95903 and 95904 were deleted beginning Jan 1 2013 You will need to consult your 2013 CPT book for the appropriate codes.

 

[aruiz1231@yahoo.com]

these are claims from last year, I also add modifier -59, but they are still being rejected and yes all your help is greatly appreciated, thank you

 

[airart]

Add On Code to an Add On Code?

I got this answer from another thread that came up in a search on this same topic.

95886 is an add on code to an the add on code 95885.

95885 is a needle EMG, each extremity, limited - bill with primary procedure. (covers 1-4 studies)

then add; 95886 - complete; (for 5 or more muscles studied)

I think they enjoy making us crazy. hehe

 

[seanny]

Some payors deny the 95904 etc with the -59 modifier, especially BCBS. You can try billing them in units (ie 95904 x 4) which may get them to pay. Otherwise, you may have to appeal them and include the CPT guidelines and NCS report.

The 95886 is an add-on code, so it does not need the -59 modifier, but may need the -50 mod (for Mcare and others) if bilateral, or the -RT &-LT mods if BCBS, in my experience.

 

[aruiz1231@yahoo.com]

I just want to make sure I can code it correctly, because we keep getting either partial payment or a denial, when I code 95886 it is necessary to code 95885 also 95903-59 and 95904?

 

[aruiz1231@yahoo.com]

Thank you all so much for your help it's been awesome!