Neurology & Pain Management Coding Alert

Question: A primary care referral source recently contacted our neurology practice to ask how to report pre-configured nerve conduction tests that they are performing. They didn't give us much more information than that. What might they be looking for?

New Mexico Subscriber

Answer: More than likely they are looking for the correct code to use for a pre-configured nerve conduction study (NCS). You'll need to get more details on what actually took place during the exam, but you might turn to 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).

Internists are more likely to perform a pre-configured NCS (95905). Neurologists typically perform NCS with individually placed stimulating, receiving, and ground electrodes, which you would report with 95900-95904 (Nerve conduction, amplitude, and latency/velocity study, each nerve...).

Look: Units of service for 95905 are based on each extremity tested, not per nerve. For example, if an internist tested both upper extremities with the pre-configured device, she would bill 95905 with two units of service. Units for other NCS codes, such as 95900 (... motor, without F-wave study), are based on each nerve or nerve branch studied.

Finally, note that, like the standard NCS that your neurologist performs, 95905 also has separate professional and technical components. Often the primary care providers that perform these pre-configured diagnostic studies provide the global service, so the code is reported without any modifiers. However, some primary care practices elect to only perform the technical component and would append modifier TC (Technical component) to 95905 and have an outside specialist perform the official interpretation and report.