Neurology & Pain Management Coding Alert

Question: When our doctor orders a SNF (skilled nursing facility) patient to have diagnostic tests done at our office, they are denied by Medicare even though we use office as the place of service. Medicare still identifies the patient as being in a SNF. We are interested to know how the patient can have these tests performed. The EEG can be done in a hospital setting, but the EMG and NCS cannot only be in 'office' to get reimbursed.  So how does one get paid if patient needs to have this testing?New York SubscriberAnswer: You can perform tests like EMG and NCS on a SNF patient in the office. However, you only bill Medicare Part B for the professional component of the diagnostic studies by appending the modifier 26 (Professional component) to the CPT® code.  Regardless of where the diagnostic study was performed, i.e. the physical location, Medicare includes the [...]