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Upper and Lower EMG/NCS same day

Heather Posted Mon 22nd of October, 2012 18:41:12 PM

My Dr. did an upper and lower emg with ncs on the same day. The diagnosis is the same for both extremities. How would I bill Medicare to not get a duplicate rejection?

EMG 1 EXT Upper
EMG 1 EXT Lower
95904 RT Upper x 3
95904 RT Lower x 2
95903 RT Upper x 4
95903 RT Lower x 4

Thank you in advance.

SuperCoder Answered Tue 23rd of October, 2012 18:36:17 PM

1.Use primary code (95900, 95903, or 95904) for NCS depending upon the type of study (motor without F-wave, motor with F-wave, or sensory). Repeat the code as per number of nerves studied with appropriate modifiers. If the physician tests more than one place on a nerve, you still only report the code once. Tests to multiple nerves in an extremity get multiple codes; tests to multiple locations of a single nerve get a single code. There is no bundling between 95903 and 95904, so can be used together with appropriate modifiers.
2.Also report code (95885 or 95886) for EMG depending upon number of muscles studied. This code should be reported once per extremity. Example: when 4 or less muscles each of all four extremities are studied, report 95885 four times. These are Add-on codes, so do not use modifier 59.

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