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New EMG Codes (95885/95886/95887)

Frank Posted Wed 01st of February, 2012 04:41:32 AM

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

SuperCoder Answered Thu 02nd of February, 2012 15:19:22 PM

CPT codes 95900 and 95903 may be billed together for the same patient on the same day of service when multiple nerves are tested, some with and some without F waves, because in that case they describe 2 distinct and independent services provided on the same day.
*
However, CPT codes 95900 and 95903 cannot be billed together for the same nerve in a given patient on a given day. It is appropriate to add modifier -59 when billing 95900 and 95903 to indicate separate and distinct procedures on the same patient on the same day.

Frank Posted Fri 03rd of February, 2012 04:05:59 AM

Thanks for the reply. What would the Qualifying Service" be for 95886?

SuperCoder Answered Mon 06th of February, 2012 10:44:34 AM

I hope this link will answer your queries:
http://www.aan.com/globals/axon/assets/9099.pdf

Maqbool Answered Fri 10th of February, 2012 03:25:08 AM

very informative link, thnx Sanjit! It solves a lot of issues.

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