Neurology & Pain Management Coding Alert

Question: If a new patient presents for a nerve conduction study and the neurologist does a brief workup, can I charge an E/M code as well? If the patient comes back to go over the results, what code do I use?

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Answer: Yes, you can charge an E/M along with a nerve conduction study (95900-95904). Which E/M depends on whether the visit met the criteria for a consult (99241-99245) (request from the primary physician, report sent to the primary physician, and recommendations made for the patients care) or for an initial office visit (99201-99205). If the patient is coming back to go over test results, you should bill an established patient visit (99211-99215). However, the neurologist should also conduct an exam, not just go over the results. The minimal exam requirements still need to be met.

Note: Although it is no longer specifically required as per Correct Coding Initiative (CCI) edits, many coding experts consider it proper coding to bill the E/M with modifier -25 (significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) attached to inform carriers that the E/M performed was above and beyond what is included in the nerve conduction study codes.