Neurology & Pain Management Coding Alert

Question: We submitted codes 95903 and 95905 for nerve conduction studies during the same patient encounter. The payer bundled 95905 into 95903, but still reimbursed separately for both codes. Why are these procedures bundled together, yet still payable?

Wisconsin Subscriber

Answer: First, take a close look at the codes you're reporting:

• 95903 -- Nerve conduction, amplitude and latency/velocity study, each nerve; motor, with F-wave study
• 95905 -- Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes F- wave study when performed, with interpretation and report.

A provider won't normally perform both the pre-configured motor and sensory testing and then also conduct a separate motor nerve conduction study with F-wave studies during the same encounter. Typically, primary care providers perform the pre-configured testing (95905) in their offices as preliminary testing, while neurologists or psychiatrists typically perform the standard/complete nerve conduction studies (95900-95904). CPT® specifies, "Do not report 95905 in conjunction with 95885, 95886, 95900-95904, 95934-95936". This would be applicable for all payers.

According to Correct Coding Initiative (CCI) edits, 95905 is bundled into 95903 because the code description makes it appear that the motor testing was double billed ("motor and/or sensory nerve conduction, using preconfigured electrode array[s], amplitude and latency/velocity study, each limb, includes F-wave study when performed, with interpretation and report" and "Nerve conduction, amplitude and latency/velocity study, each nerve; motor, with F-wave study").

Double check the documentation to verify the type of diagnostic testing your physician actually performed; perhaps the charge ticket was mismarked.