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modifer usage for facility based EMGs

  1. #1
    Location
    Bay City, Michigan
    Posts
    156
    Default modifer usage for facility based EMGs
    Medical Coding Books
    I am new to Neurology, and could use some help. I have a new neurologist who is doing EMG's. More specifically, the first portion of the test (skin electrode nerve conduction) is being performed by a tech, the physician is doing the second portion of the test (needle conduction). Dr is providing the interpretation of these studies.

    I don't believe I can bill globally because Dr is not providing this service in his office, he is providing in the out patient setting at our hospital. Equipement is owned and tech is employed by the hospital. An example of codes he is submitting is 95908 -nerve conduction study, 3-4 studies and 95886 -needle electromyography.

    Would I bill both of these CPTs with modifier 26?

    And...I don't think it makes a difference...but worth mentioning....Dr is employed by same hosptial....

  2. #2
    Location
    Denver Colorado
    Posts
    287
    Default
    Modifier 26 would be appropriate in your scenario. Medicare does not allow payment to the physician for the technical component of diagnostic tests in a facility site of service.

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