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EMG Coding for Work Comp

Pauline Posted Fri 01st of March, 2013 16:50:19 PM

Can you tell me if Work Comp is requiring the new 2013 codes for EMG Never Conduction Studies or do they still require the 95903, 95904, 95861, etc.?

SuperCoder Answered Sat 02nd of March, 2013 00:12:10 AM

Specific state rules govern the effective date of CPT code changes for workers compensation, so your state workers compensation payers may not be using the most current CPT code book to process claims at this time. In those cases, you will continue reporting the codes appropriate for that payer.

Pauline Posted Mon 04th of March, 2013 20:46:46 PM

The state in question is California. I cannot find information or get anyone on the phone to confirm what work comp in California requires for emg coding. Would you know?

SuperCoder Answered Tue 05th of March, 2013 21:43:06 PM

Let us check if we find something regarding that.

SuperCoder Answered Wed 06th of March, 2013 01:57:16 AM

California workers compensation for physician services is still using the 1997 CPT codes. Supposedly they will be transitioning to a new physician fee schedule based on Medicare's RBRVS system & likely more current codes starting in 2014.

Here is a link to the California WC website that has an e-mail address that the requestor can get additional information:

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