Neurology & Pain Management Coding Alert

Test your coding knowledge.  Determine how you would code this situation before looking at the box below for the answer.
Question: Is modifier -50 appropriate with 95900 if the patient has bilateral carpal tunnel syndrome (CTS)? Medicare allows four units for bilateral CTS and three units for unilateral CTS.

Arkansas Subscriber

Answer: Modifier -50 (bilateral procedure) is not appropriate when performing motor nerve conduction studies (95900, nerve conduction, amplitude and latency/velocity study, each nerve; motor, without F-wave study) on the right and left upper extremity. Rather, bill one unit for each test, e.g., 95900 x 2 for a single test on each extremity. Report only one unit for multiple sites on the same nerve. When both the stimulating and recording electrodes are moved to different locations, coding for multiple units is appropriate. Do not append modifier -51 (multiple procedures) to subsequent codes. For Medicare patients, attach modifiers -LT (left side) or -RT (right side)
as appropriate.
 
As you note, some carriers may limit the number of nerve conduction studies that may be performed during a given period, so check with your local carrier before billing.