Wiki Neurology Coding Help

[KJ4AAPC]

Hello,

I am hoping that I can find some help with Neurology coding. I have been searching for resources and there doesn't seem to be very many available. This particular Neurologist does not perform surgeries, only outpatient care. Does anyone know of any good resources that help with coding guidelines?

I have billed a 95937 with 3 units for 3 different nerves, and a 95911. The diagnosis is acceptable according to the LCD, and I have received a denial from Medicare. Any suggestions?

 

[mhstrauss]

I'd be happy to try to help--I work for a Neurology group. What exactly is the denial? Dx? Can you post a copy of the scrubbed report?

 

[marvelh]

Just a thought: some Medicare contractors include the following type of verbiage in their LCD coverage policies -
In most instances, both NCS and usually EMG are necessary to perform diagnostic testing. While a provider may choose to perform just a NCS, when performed alone it is usually considered be a screening exam. The only exception to this is a situation when a provider may consider it appropriate to perform a NCS without doing an EMG for the diagnosis of carpal tunnel syndrome with a high pre-test probability.

They may not be viewing the neuromuscular junction testing as meeting their requirements of EMG testing when performed with the NCS testing and your diagnosis code likely isn't carpal tunnel syndrome.