Neurology & Pain Management Coding Alert

Answer: You should report limited muscle studies (95870, 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) per limb. Therefore, when testing two extremities, report 95870 and place a "2" in the unit's box of the CMS-1500 or other claim form. When providing the tests in a facility setting or using equipment not belonging to the reporting physician, append modifier -26 (Professional component) to the claim.

According to Medicare's Physician Fee Schedule, modifier -50 (Bilateral procedure) is not appropriate to 95870 (column S of the Fee Schedule includes a 0 indicator). When billing for multiple limbs, however, you may choose to attach modifiers -LT (Left side) and -RT (Right side) to specify that the neurologist tested different limbs. Alternatively, append modifier -59 (Distinct procedural service) to the second and subsequent units of 95870 to specify that the physician tested several distinct anatomic locations.