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Nerve Conduction Studies - 59 Modifier

  1. #1
    Default Nerve Conduction Studies - 59 Modifier
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    Hello there,

    I know this topic has been discussed in the past and I am also aware of the table located in Appendix J of the CPT book.

    I am wondering if anyone is familiar with the usage of the 59 Modifier for NCS,
    when it is appropriate, and if it even makes sense to use it for these studies.

    For Example: according to the Table, the maximum number of studies for CPT 95904 for Radiculopathy is 2. If my physician indicates 4 studies were done would I bill the 95904 once with 2 Units then add a second line of 2 Units with a 59 Modifier?
    Or would I bill 4 Units on one line with a 59 Modifier?
    Also how would this differ from using the 76 Modifier?

    Any information/ideas would be welcome.

    Thank you.

  2. Default nerve studies & units
    did u get answer to this questions Im looking for the same answer my provider has indicated he conducted a 95904 x 6 each would i bill three time on claim with 2 units per line with 59 modfiier on 2nd & 3rd?

  3. #3
    Columbia, MO
    NCV tests are for each nerve so you should bill a line item for each separate nerve tested. So if 4 were done then 4 line items with a 59 on the second and subsequent. I have always billed this way and I have never had any issues with reimbursement.

    Debra A. Mitchell, MSPH, CPC-H

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