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EMG Billing

  1. Question EMG Billing
    Medical Coding Books
    I cannot get Medicare to pay for two limited EMG studies (95870X2) on the same date. They will pay full EMG studies for up to four limbs (95860,95861,95863,95864), but they keep stating that it is not payable. I don't want to have my doc's unnecessary stick people more than five times if it is not warrented anyone else having this problem?

  2. Smile Emg
    It could be your diagnosis code

  3. #3
    Location
    Duluth, Minnesota
    Posts
    1,133
    Default
    or, maybe you need a modifier - like 59 or 76 why was it done twice ? repeat same extremity? second time different extremity?
    Donna, CPC, CPC-H

  4. Default
    Different extremity. I've tried the 59 mod, and still get denied. It's frustrating when billing full extremity EMG's other codes are offered but not for the limited studies.

  5. #5
    Location
    Evansville Indiana
    Posts
    451
    Default Emg
    Have you tried billing it with a RT and LT? Generally I have found that x2 will get denied but if you identify that it is two different sides they will pay.

  6. Default
    Tried that as well...Medicare has paid you?

  7. #7
    Location
    Flower City
    Posts
    24
    Default
    Be sure you are using 95870 for muscles other than thoracic paraspinal (95869) paraspinal, cranial nerve supplied muscles..........
    If it is two extremities, identify by LT or RT or RT, RT and the modifier -59 - may need that combination.

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