Neurology & Pain Management Coding Alert

Question: How should I code nerve conduction studies when the neurologist tests four nerves bilaterally: 95903-LT x 4 units and 95903-RT x 4, or 95903-50 x 8?


South Dakota Subscriber

Answer: You cannot use modifier -50 (Bilateral procedure) with nerve conduction study codes 95900-95904, according to the 2005 Medicare Physician Fee Schedule database.

In this case, rather than billing out one line item with eight units in 24G (a quantity that most payers would not reimburse without appeal), try separating them into two line items, such as 95903-LT (Nerve conduction, amplitude and latency/velocity study, each nerve; motor, with F-wave study; Left side) x 4 units and 95903-RT (Right side) x 4 units. The -RT and -LT modifiers will indicate to the payer that your physician did perform four studies on each side.

Be sure to have your documentation readily available because many payers still balk at reimbursing this number of motor nerve tests. They'll want to ensure that each nerve tested is separate by definition.