Neurology & Pain Management Coding Alert

Question: When we bill 95900, do we bill it once per nerve even if we're reporting for different branches of the same nerve that our neurologist is testing? For example, for the tibial nerve all the way to the ankle and foot, branching to the medial plantar and lateral plantar nerve, do we still report 95900 once or would we bill this as two units?

Tennessee Subscriber

Answer: When reporting 95900 (Nerve conduction, amplitude and latency/velocity study, each nerve; motor, without F-wave study), bill for each nerve or separate nerve branch that your neurologist is testing. Thus, if your neurologist tests both the medial and lateral tibial nerves in your example, you bill two units. Appendix J of the CPT codebook is helpful in determining what constitutes a separate nerve or nerve branch. For example, the tibial motor nerve has three separate branches that can potentially be reported separately, i.e. the Inferior calcaneal branch to the Abductor digit minimi muscle, the Medial plantar branch to the Abductor hallucis muscle and the Lateral plantar branch to the Flexor digiti minimi brevis muscle. Per the CPT Appendix J guidelines "Each nerve constitutes one unit of service."