Uhc & emg 95886 add on denial for max qty


Local Chapter Officer
Clearwater, FL
Best answers
I have done everything I could to research this further. No matter how I bill this whether it is 1, 2, 3 or 4 units on line line item it denies. It does not do this for ANY OTHER carrier. This billing for up to 4 units per line item was acceptable until 2015- mid 2016, then late 2016-early 2017 they were accepting if we billed 2 units on 1 line item, then the 3-4 unit on the second line item with the mod-59 but usually that 3rd or 4th unit went to PR. They paid fine that way until mid-2017.

Since then they are denying anything OVER 2 units in 1 day. I know they have to have the EMG to get paid for the NCV. I would hate for patients to have to come back another day for extra units. UHC Max Freq per day shows they only allow 2 units per day on 95886 even through AMA says that they can have up to 4 units per day if all 4 limbs are getting done. I do not have issues w/other carriers billing up to 4 units on one line item, but UHC has been my nightmare.

I see that codes standard EMG codes that can be used. Can you used codes 95860-95864 when we are billing the 95886 add on code to get these extra units paid? Only issue I see is that UHC only allows 1 unit per day on those codes so that might satisfy the 3rd limb but still doesn't help the 4th unit. Can someone please help shed some light on this issue and what they have been able to do to get all units paid by UHC for the same day or is my only option to have them come back another day and used coded 95907-95913 as applicable?