Neurology & Pain Management Coding Alert

Question: One of our coders says we can bill multiple units for the EMG guidance with chemodenervation (95874). Is this true?

Texas Subscriber

Answer: Although you can only use one injection code per region (limbs, face, etc.), you can report multiple guidance codes for that patient when needed.
 
Submit the appropriate code from 64612-64614 (Chemodenervation of muscle[s]) for the injection, then report +95874 (Needle electromyography for guidance in conjunction with chemodenervation [list separately  in addition to code for primary procedure]) for the EMG guidance.

CPT includes several notes to help you report 95874 correctly:

- Use 95874 in conjunction with 64612-64614 (Chemodenervation of muscle[s]). 

- Do not report 95874 in conjunction with +95873 (Electrical stimulation for guidance in conjunction with chemodenervation [list separately in addition to code for primary procedure]).

- Do not report 95874 in conjunction with 95860-95870 (Needle electromyography).

Caveat: Some policies might stipulate that you can only report one EMG per date of service, regardless of the number of sites. Also check with the carrier before submitting your claim to be sure you follow the correct guidelines.