Neurology & Pain Management Coding Alert

Question: A new patient was referred to our office for a nerve conduction velocity test (NCV). The doctor billed 95910 and 95886. Can he charge a new patient code the next time the patient comes in since he didn’t report a new patient code for the NCV visit? 

Washington Subscriber

Answer: When the patient returns for an office visit, the physician will need to report the appropriate E/M code for an established patient (99212-99215, Office or other outpatient visit for the evaluation and management of an established patient …). 

Here’s why: Although it may be the patient’s first office visit, the patient has already established care with your physician through the nerve conduction study. This is due to CPT® guidelines that although it was not a typical office visit, the provider had a face-face encounter with the patient when providing NCV testing.