tci Part B Insider - 2010 Issue 26

Reader Question: Counting Nerve Conduction Test Per Limb Will Result in Denials

Question: I coded my physician's diagnostic testing recently that included nerve conduction studies, an EMG, plus H-reflex testing. The doctor's final diagnosis was S1 radiculopathy (723.4). I billed all of the appropriate codes, plus an E/M code with modifier 25 in the following sequence:99213-2595903-LT x 295903-RT x 295904-LT95904-RT95934-LT95934-RT95861.The patient's MAC denied a lot of the diagnostic studies. Why didn't we get paid for the full services provided?Answer: When your physician performs a nerve conduction study (NCS) and you code 95903 (Nerve conduction, amplitude and latency/ velocity study, each nerve; motor, with F-wave study) or 95904 (...

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