Neurology & Pain Management Coding Alert

Question: What documentation should I use to support the codes and quantity I bill for our physician's interpretation of nerve conduction studies and EMGs? One person recommended I follow the physician's interpretation, but someone else recommended the machine's printout.  

Arizona Subscriber

Answer: Having a report that indicates your physician read and interpreted the report is enough to justify billing 95903 (Nerve conduction, amplitude and latency/velocity study, each nerve; motor, with F-wave study) or other nerve conduction studies. Remember, however, that you report 95900-95904 only once when the physician stimulates or records multiple sites on the same nerve.

Modifier watch: If your neurologist performs the study in another facility, you probably need to append modifier 26 (Professional component) to indicate you-re only coding the professional aspect of the procedure. The facility will submit the procedure code with modifier TC (Technical component) because it owns the equipment.

Note: If the facility and provider are one and the same and the physician performed, read and interpreted the test, you won't append any modifiers.
 
If you can't get all the coding answers from the physician's documentation, turn to the printout for additional information. Many coders cross-reference charts and other documentation to complete their claims. Any information that ensures you correctly code procedures is a valuable resource.

 -- Clinical and coding expertise for You Be the Coder and Reader Questions  provided by Neil Busis, MD, chief of the division of neurology and director of the neurodiagnostic laboratory at the University of Pittsburgh Medical Center at Shadyside, and clinical associate professor in the department of neurology, University of Pittsburgh School of Medicine; and Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, CodeRyte Inc. coding analyst and coding review teacher.