1. Try Super
   Posted 3 months ago #
   

   What modifier would i use to bill an emg/ncs of the upper extremities? 50 or 59

2. SuperCoder
   Posted 3 months ago #
   

   What code(s) are you reporting and what is the clinical situation (multiple NCS tests on one nerve, different nerves, etc.)? How you use the modifiers will depend on the codes.
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   When reporting an NCS, you should remember that you can only report a single unit of service when your physician does the study at multiple sites on the same nerve. Hence, you count the nerves and not the number of sites where the recording is done during the examination.
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   The CPT® descriptors for codes 95900, 95903, and 95904 mention ‘each nerve’. You hence report the codes for every individual nerve that is investigated.
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   When your physician may performs the recording in two branches of the same nerve or test different nerves in the same setting. In these instances, you’ll need to apply the appropriate modifiers to earn full pay.
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   Example: Your physician, while attempting to study the nerve conduction in the right hand, may record the velocity of conduction in the recurrent branch of the median nerve (C8, T1) that supplies the abductor pollicis brevis in the thumb and also does the NCS with F-wave recording in the deep branch of the ulnar nerve that supplies the abductor digiti minimus. In this case, you would report 95900 for the NCS in the median nerve and 95903 for the second one in the ulnar nerve. You append modifier 59 (Distinct procedural service) to the 95900 code to specify that your surgeon did a separate motor NCS on a different nerve.
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   When your surgeon does the NCS in different nerves and does the F-wave recording in only one, you should report code 95903 on the first line as it is describing the more substantial procedure.
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   You then report 95900 with modifier 59 for the additional, separate median motor nerve to the abductor pollicis brevis. Tip: To justify reporting the testing in two separate and distinct nerves (one of which involves an F-wave recording), your physician’s clinical notes should clearly specify the two recordings. You can challenge any denial if you have appended the modifier 59 appropriately.
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   Best,
   Leesa
   *
   Leesa A. Israel, BA, CPC, CUC, CMBS
   Executive Editor, The Coding Institute
   Manager, TCI Consulting & Revenue Cycle Solutions
   Email: leesai@codinginstitute.com
   http://www.codinginstitute.com

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