Neurology & Pain Management Coding Alert

Question: What is the appropriate method to bill for "inching" (that is, multiple nerve conduction study [NCS] testing) along the ulnar nerve? The test is very time-consuming, and payers have rejected our claims in the past.

Rhode Island Subscriber

Answer: "Inching" describes a process of incrementally moving the stimulating electrode away from the recording electrode, which remains stationary through out the test. In this way, the physician can pinpoint the exact location of the problem along the nerve. Because only one electrode is moved, however, you may report only a single unit of 95900-95904, as appropriate, no matter how many "readings" the physician takes.

Clinical and coding expertise for You Be the Coder and Reader Questions provided by Neil Busis, MD, chief of the division of neurology and director of the neurodiagnostic laboratory at the University of Pittsburgh Medical Center at Shadyside, and clinical associate professor in the department of neurology, University of Pittsburgh School of Medicine; and Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, director and senior instructor for CRN Institute, an online coding certification training center based in Absecon, N.J.