Neurology & Pain Management Coding Alert

Question: How should I report limited muscle study EMG for the left and right arms? Can I report 95870-50?


Maine Subscriber

Answer: You should report limited muscle study electromyography per limb using 95870 (Needle electromyography; limited study of muscles in one extremity or non-limb [axial] muscles [unilateral or bilateral], other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters). For testing both the right and left arms, therefore, claim 95870 and place a -2- in the units box of the CMS-1500 or other claim form.

Medicare guidelines stipulate that you should not append modifier 50 (Bilateral procedure) to 95870. When the neurologist tests -bilateral- limbs, however, you may attach modifiers LT (Left side) and RT (Right side) to clarify that you are not double- billing. Or you may append modifier 59 (Distinct procedural service) to the second and subsequent units of 95870 to specify that testing occurred at distinct anatomic locations.

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, director and senior instructor for CRN Institute, an online coding certification training center based in Absecon, N.J.