Neurology & Pain Management Coding Alert

Question: We performed a complete nerve conduction study but there was no response from the nerve. How should I code for a nerve conduction study that is unobtainable? New Mexico Subscriber Answer: If the nerve conduction study (NCS) was indeed performed and completed, you should consider the lack of response by the concerned nerve or in other words an "unresponsive or unobtainable result" diagnostic and therefore reportable. "An amplitude of zero does not mean the study was not done," says Neil Busis, MD, FAAN, clinical associate professor, department of neurology at the University of Pittsburgh School of Medicine. "In fact, it may have taken more work than a nerve conduction study on a normal nerve. You can certainly bill for studies in which the response was not obtainable. Patients with bad neuropathy have this all the time." Neurologists should include clear documentation of  all separate and distinct nerve conduction studies [...]