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EMG - Units to bill

Guna Posted Tue 27th of January, 2015 09:31:02 AM

Could you please help me out to find the maximun units for CPT 95886 (EMG),since we are using 4 units but it won't be get paid. Please update how many units do we report to this CPT 95886. Thanks

SuperCoder Answered Tue 27th of January, 2015 10:38:11 AM

Thanks for your question. 95886;Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels is used in addition to the code for the primary procedure. Use this code once per extremity.

Because +95886 is an add on code, payers will not reimburse you if you report it without an appropriate primary code, which you can report using codes 95905 to 95913, Nerve conduction tests. You can report +95886 once for each extremity tested, so you can report this code four times if all four extremities are tested.

Remember that these extremity EMG codes includes testing of the related paraspinal areas, cervical paraspinal muscles for upper extremity testing and lumbar paraspinal muscles for the lower extremity testing, so do not separately report EMG testing of these paraspinal muscles when performed as part of the extremity EMG diagnostic testing.

You should check your payers for guidance on how they would like 95886 submitted when there are multiple extremities. Some payers will take units with 95886 and other payers prefer separate lines with a modifier attached. Hope this helps.

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