SuperCoder Posted Wed 16th of March, 2011 14:39:20 PM
95903 with 4 units and 95904 with 6 units got denied for to many units ??? i am new to radiology is this correct or do i need a 59 mod.
SuperCoder Answered Thu 17th of March, 2011 09:04:36 AM
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.
Append modifier 59 (Distinct Procedural Service) to indicate that a separate, distinct nerve was studied.