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WHY AM I BEING DENIED FOR CODES 95900 AND 95904, EVEN WITH A 59 MODIFER?

Peter Posted Tue 04th of September, 2012 22:09:52 PM

MEDICARE IS DENYING EMG CODES 95900 AND 95904, WITH A 59 MODIFER. MEDICARE STATES I AM MISSING ANOTHER MODIFER. WHAT OTHER MODIFER DO I NEED?

SuperCoder Answered Wed 05th of September, 2012 14:11:08 PM

A sensory or mixed nerve conduction study, 95904, is often done on the same nerve with a motor nerve study, 95900 or 95903. Payers often do not understand the difference between these two and often deny paying for both. Submit documentation with the claim outlining the differences and various conclusions from the two nerve conduction studies, and show medical necessity.

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