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EMG testing 95870

  1. Default EMG testing 95870
    Medical Coding Books
    We billed a 95870 with 2 units for a Medicare patient and it was denied as missing/incomplete/invalid days or units of service.

    The documentation states:

    EMG evaluation of selected left upper extremity muscles, normal.
    EMG evaluation of selected right upper extremity muscles, normal.

    After further review, less than 3 muscles were tested in the left & right upper extremities.

    Are we billing it correctly? It went in w/95870 with 2 units. OR should we be billing it on 2 separate lines, with mod 59 appended to the 2nd 95870?

    Can someone help us....please?

    Thank you!

  2. Default
    I had the same problem - it goes out like this:


  3. Default
    Thanks for your input I really appreciate it. However in our case, I think the GP mod wouldn't apply. Our Physiatrist performed it in her office and the testing was done on the RT & LT....I know mod 76 is for a repeat procedure performed by same physician, in this case because 2 anatomical sites, maybe mod 59 would be a better code choice?

  4. Default
    Nope - I tried the mod 59 first & it didn't work for Medicare. I bill for PT - done in office.
    The GP mod should be on all PT codes when they go out.

  5. Default
    Ok Thanks!

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