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Neurosurgery Coding Alert

Reader Question:

Be Aware of In-Office NCS Testing Rules

Published on Wed Mar 28, 2007

Question: A product representative recently sold us nerve conduction study equipment that he referred to as a -one-button- hand-held device. I just heard that some insurers say we can't bill the regular nerve conduction study codes for using these machines. Is this accurate?


North Carolina Subscriber


Answer: The answer depends on the specifics of the device that you bought, but in general, many insurers have published guidelines stating that -one-button- devices are not billable with codes 95900-95904 (Nerve conduction). For example, Cigna Medicare (a Part B carrier in Tennessee, Idaho and North Carolina) recently published an FAQ that refers to a sudden spike in billing NCS testing due to -the availability of equipment that would allow in-office testing generating immediate results.-

The problem: These in-office devices don't meet the current descriptors for 95900-95904, Cigna says. If you use one of these devices, you should bill using unlisted-procedure code 95999 (Unlisted neurological or neuromuscular diagnostic procedure).

Resource: See Cigna's FAQ, www.cignamedicare.com/medicare_dynamic/FAQs/Display.asp.
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