Neurology & Pain Management Coding Alert

Don't let a CPT instruction fool you into assuming all additional nerve conduction tests count as inclusive.

CPT contains a parenthetical note indicating you should -report 95900, 95903, and/or 95904 only once when multiple sites on the same nerve are stimulated or recorded.- This CPT instruction clarifies that testing a single nerve in any of the three nerve conduction CPT codes includes all different stimulation sites along the individual sensory, motor, or mixed nerves your neurologist tests, says Marvel Hammer, RN, CPC,CCS-P, PCS, ACS-PM, CHCO, owner of MJH Consulting in Denver.

Despite these inclusions, the following circumstances support separately billing the additional NCS:

1. When nerve conduction studies are performed on two distinct branches of a given motor or sensory nerve,report more than one code from the 95900-95904 series.

2. Coders should also be aware that most nerves have a contralateral counterpart, and your neurologist may find it necessary to perform bilateral testing for comparison. If this is the case, you may report separately the individual nerve testing on each side.

3. Finally, the motor (95900 or 95903) nerve conduction testing is distinct from sensory (95904) NCS, even though the nerve may carry the same -name.- For example, motor NCS on the Median nerve to the abductor pollicis brevis (ABP) muscle is separate and distinct from a sensory NCS on the Median nerve to the first digit. Both of these diagnostic studies may be separately billed with the corresponding CPT code.