Answer: According to the current HCPCS manual, A4215 (needles only, sterile, any size, each) in combination with 95860 (needle electromyography [EMG], one extremity with or without related paraspinal areas) is not covered by or valid for Medicare or most third-party payers, says Catherine A. Brink, CMM, CPC, president of Healthcare Resource Management Inc., a practice management and reimbursement consulting firm in Spring Lake, N.J., that consults with several neurology practices. The Health Care Financing Administration (HCFA) considers billing A4215 in addition to code 95860 as unbundling the procedure because compensation for the needle is included in the payment amount for the needle EMG. Therefore, A4215 should not be billed separately. |