Neurology & Pain Management Coding Alert

Question: Is there a code for surface EMGs?

Alaska Subscriber

Answer: CPT provides no code for surface electromyography (EMG) other than 95999 (Unlisted neurological or neuromuscular diagnostic procedure), according to the American Association of Electrodiagnostic Medicine (AAEM). To ensure payment, you should get prior approval from the payer and attach documentation. In your documentation, include the procedure code that compares to surface EMGs in terms of skill, overhead, risk and relative value units to help justify the charge you are submitting. You should also ask the payer if there is another acceptable substitute code that it would prefer or allow you to use.

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, consultant and CPC trainer for A+ Medical Management and Education, Absecon, N.J.