Neurology & Pain Management Coding Alert

Question: My neurologist received payment from Medicare for the EMG and other nerve conduction studies she performed. However, we received a denial for billing 95900, saying it is not covered when performed during the same visit. How can I get reimbursement for this?

Oregon Subscriber

Answer: If 95900 (Nerve conduction, amplitude and latency/velocity study, each nerve; motor, without F-wave study) is truly distinct from the other services you reported, try resubmitting the claim with modifier 59 (Distinct procedural service) included. For example: For example: If you are billing 95900 with 95903 (... motor, with F-wave study), you need to add a modifier to 95900 if motor nerve conduction study without the latency F wave study is performed on a separate and different nerve. You can read Medicare's article on proper use of modifier 59 online at http://www.cms.hhs.gov/NationalCorrectCodInitEd/Downloads/modifier59.pdf.