Neurology & Pain Management Coding Alert

Question: My doctor has started doing EMG procedures/tests in an inpatient hospital setting. Should I report these EMG tests any differently than when he performed this service in our office? New Mexico Subscriber Answer: The codes you'll use for the procedures will be the same: electromyography (EMG) codes 95860- 95872 (Needle electromyography ...). You do, however, need to append modifier 26 (Professional component) to the EMG code. This indicates you are billing only for the professional component (the interpretation of the test). You should be clear for this portion of the diagnostic study as long as your documentation proves the payer's requirements, such as medical necessity. Technical component: If your neurologist provides all of the technical components of the test -- the computer, supplies, and other equipment -- in addition to performing the test, you should contact the facility for reimbursement rather than bill your payer. You will need to clarify where, [...]