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EMG Codes effective 1/1/2012

Linda Posted Tue 10th of January, 2012 16:51:44 PM

Do we use 95886 & 95887 as add on codes and continue to bill 95860 &
95861

SuperCoder Answered Mon 23rd of January, 2012 18:58:12 PM

Linda,

95886 and 95887 should be reported as add-on codes only when nerve conduction studies (95900-95904) are also performed. If your physician performs an EMG but does not perform nerve conduction studies, then instead use the EMG-only codes (95860, 95861).

Double add-ons may be okay: CPT explains the usage of the new EMG codes in its “electromyography” introductory notes, where it states, “Report either 95885 or 95886 once per extremity. Codes 95885 and 95886 can be reported together up to a combined total of four units of service per patient when all four extremities are tested.”

Information from Part B Insider (Multispecialty) Coding Alert, October 2011

Jen Godreau, CPC, CPMA, CPEDC
Director of Development & Operations
SuperCoder.com from the Coding Institute

Frank Answered Tue 31st of January, 2012 22:28:54 PM

Need some guidance please.

Billed the following, with the following denials:

95903 x2 units Denied for needing a Mod
95904 x2 units Denied for needing a Mod
95868 m59 x2 units Denied for max 1 unit/day
95869 m59 x1 units Allowed and Paid
95886 x1 units Denied for Global/Qualifying Service Missing/Not Identified

Why do the NCS codes (95903/95904) need a Mod?
What service does 95886 need as a qualifying service?
Why can the Doc only do 1xunit of 95868?
What should the correct coding be?

Thanks!
Eli

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