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: CPT 2001 defines 95904 as a "sensory or mixed" study. Does this mean that when billing for motor and sensory nerve conductions on the same nerve we should use 95904 instead of a combination of 95900 or 95903 and 95904?

Florida Subscriber
  Answer: In CPT 2002, 95904 (nerve conduction, amplitude and latency/velocity study, each nerve; sensory) has been modified to eliminate "or mixed" from its descriptor and is not appropriate to report a combination of motor studies with or without F-waves on the same nerve. As used in the descriptor for 95904, "mixed" referred to the type of nerve (mixed nerves contain both sensory and motor fibers), not to sensory and motor nerves tested concurrently. Do not bundle conventional nerve conduction studies, 95900 ( motor, without F-wave) and 95903 ( with F-wave), into a single mixed or sensory nerve conduction study (NCS). If performed, report these procedures separately.
 
For instance, if providing NCS to diagnose carpal tunnel syndrome, the median mixed nerve, median sensory nerve and median motor nerve may all be tested. In this case, 95904 (x 2) and 95900 or 95903 (as appropriate) may be separately reported. If the carrier rejects the claim, attach modifier -59 (distinct procedural service) to the second and subsequent NCS codes.
 
If either the recording or stimulating electrode remains stationary during the study, only one unit of any NCS code may be reported. If the recording and stimulating electrodes are moved (even if to a different location on the same nerve), multiple units may be claimed. Therefore, if multiple nerves are tested, multiple units may be reported.
 
All NCS codes (95900, 95903 and 95904) are modifier -51 (multiple procedures) exempt. Therefore, when reporting testing on multiple nerves, do not apply modifier -51.