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Workers comp and CPT codes 95939 + 95938

Charlotte Posted Mon 26th of March, 2012 17:45:11 PM

We perform the neuro monitoring for spinal cord surgeries.

All other insurances pay for 95928 + 95929 except workers comp. They told me to use 92585. We received payment when we used 92585 for a few months until 2012. Now there are new codes that went into effect in 2012 according to the AMA. Now we bundle these codes if both are performed. Meaning, if MEP UPPER (95928) and MEP LOWER (95929) were both performed then you use one code for both (95939). But if there was only one MEP LOWER or MEP UPPER then you just use which ever one was performed (95928 or 95929).

I would like to know if Workers Comp is finally up to date on this code before I start using the new code (95939). I also need to know what to use instead of 92585 since Workers Comp is now denying this code.

SuperCoder Answered Wed 28th of March, 2012 08:23:17 AM

Here my question is, which state you are billing for? Worker comp plan and policy differ from state to state, locality to locality.

CPT code 95928 and 95929 are payable (by most of the worker comp as well).
It is totally wrong to use 92585 instead of 95928 + 95929. These two are unrelated CPT codes.
Yes, now (effective- 1 Jan 2012) you can use 95939 as a combination code of 95928+95929.

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