1. Danielle Catapano
   Posted 1 year ago #
   

   I work in the billing office of a Pain Management office. We do EMG Studies and my question is regarding the 59 modifier. If the study is done on more than one nerve, for example, we bill 95904, can be 3-4 nerves, we put a 59 modifier on the 2nd, 3rd & 4th nerve. Is this correct?

2. SuperCoder
   Posted 1 year ago #
   

   Append modifier 59 (Distinct Procedural Service) to indicate that a separate, distinct nerve was studied.
   ADDITIONAL INFO:
   The CPT codes 95900, 95903, and/or 95904 are used only once when multiple sites on the same nerve are stimulated or recorded.

   To qualify as a study of two or more branches of a given motor, sensory, or mixed nerve, both the stimulating and recording electrodes must be moved to different locations; in which case, it is appropriate to bill for the number of multiple units of CPT codes 95900-95904 performed.Most nerves have a contralateral counterpart; bilateral testing is often necessary for comparison purposes. Nerves on each side may be billed separately. In addition, motor CPT code 95900 or 95903, sensory CPT code 95904, and mixed sensory CPT code 95904 studies on an individual nerve are appropriately carried out and billed separately.If nephrologists submit 95900, 95903, 95904, 95934, or 95936 for ESRD, these codes are not separately payable; they are part of the monthly capitation fee. These codes are payable if submitted by other specialties when the indications are appropriate.

3. Dannell Anchcuetz
   Posted 1 year ago #
   

   I have a question regarding billing the EMG studies. The previous biller billed the 95903 with mod 59 & tc and then on another line billed 95903 59 26. Is this correct or is this just extra work? If I bill with out the 26 & TC mods but still bill 59 mod won't I get paid the same amount in the end since it is all done in the office anyway?

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