# NEW EMG code 95886 denials



## deborahcook4040

is anyone else getting modifier 26 denials on these? 

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Medicare states that "Procedure modifier was invalid on the date of service" for CPT code 95886 billed with a modifier 26 (done in a facility outpatient setting), with 2 units. NCS codes were billed as primary procedures. Any idea why these might be denying? I've received several denials for these. Maybe I shouldn't use the 26 modifier because it's an add-on code? But we still don't own the equipment, so isn't a 26 modifier required?


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## ssampor@yahoo.com

I have been getting denials too but not for the modifer and they are separating to expedite handling. So now they will have the NCS on a different EOB.. But my denial states incomplete/invalid from dates of service. Little Frustrated...


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## lizzardb

I spoke to a Medicare representative from our jurisdiction (Alabama) who said that only 1 unit of 95886 could be billed per line. More than one unit could be billed, but only 1 per line.

I hope that helps.


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## valerie75501

*95886*

Yes, I am getting denials as well.  I have been on several different sites trying to find an answer.  Someone suggested the following.  

95886 -26
95886 -59 -26

I have just billed a couple out like that.  I will respond again as soon as I have denial or reimbursement.

Val Johnson, CPC
Practical Billing Solutions, PA


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## deborahcook4040

*well... they paid part of it.*

Billing with 95886,26x2 got completely denied.
billing with 95886,26 and 95886,26,59 got the one with the 59 modifier paid, but the one without the 59 was denied. I rebilled with it 59s on both, which seems inappropriate to me, but whatever makes Medicare happy makes ME happy . Incidentally, I checked with the facility and they're getting paid for thier portion with no problems. I find that frustrating.


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## tdml97@yahoo.com

*95886*

Well, we don't split bill our EMG's but I have gotten this paid qty x 2 by Medicare MI

Have found out that if you bill a 95885 & 95886 - you need mod 59 on 95885


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