Neurology & Pain Management Coding Alert
Multiple Units of 95870
Question: Can 95870 be billed multiple times for each muscle studied? California Subscriber
Answer: Code 95870 is defined as Needle electromyography; limited study of muscles in one extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters. CMS' policy directs that 95870 can be billed at one unit per extremity. The code can also be used for muscles on the thorax or abdomen, uni- or bilaterally. You may bill one unit for studying cervical or lumbar paraspinal muscles, unilateral or bilateral, regardless of the number of levels tested. Don't confuse the number of "levels" of a single muscle tested with the number of muscles being tested. You can't bill multiple units if you are testing many levels of one muscle. However, you can bill multiple units of 95870 if you are studying multiple muscles. Sometimes it may be appropriate to bill for cervical, axial, lumbar and limb studies in the same patient with multiple units of 95870, for instance.
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