Neurology & Pain Management Coding Alert

Question: How should I report a repetitive study using an EMG machine? The neurologist says that he is not conducting an EMG or nerve conduction study.


California Subscriber

Answer: What you describe sounds like neuro-muscular junction (NMJ) testing, but check with your neurologist to be sure.

The appropriate code for NMJ is 95937 (Neuro-muscular junction testing [repetitive stimulation, paired stimuli], each nerve, any one method). Neurologists will most often use NMJ as a diagnostic test for myasthenia gravis (358.0x).

Proper diagnostic technique often requires testing of two distinct nerves/muscles. Therefore, you'll typically report two units of service. However, if the neurologist tests a single nerve before and after exercise, you should only report one unit of service per nerve and not the number of times tested during one study.

If the neurologist performed this procedure in an inpatient hospital setting, you'll report modifier 26 (Professional component) while the facility will report modifier TC (Technical component).

Your neurologist's documentation should include characteristics of the test, sites/nerves tested, rate of repetition of stimulations, and any significant incremental or decremental response for each nerve he tested.