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Neurosurgery Coding Alert

YOU BE THE CODER ~ Injections With Electromyographies

Published on Fri Jan 20, 2006

Question: The neurosurgeon performed a unilateral needle electromyography on three extremities for a patient with multiple sclerosis. During the procedure, the surgeon also injected steroids in the facet joint nerve of one thoracic level. Can we report codes for the procedure and the injection, or are they bundled?

Missouri Subscriber

Answer: Thanks to a change last year on the National Correct Coding Initiative (NCCI) edits, you can report both codes on the claim.

Starting in January 2006, coders have been able to report facet joint injections separately from electromyographies. This was possible after the NCCI unbundled the two services. (Previously, the injection was bundled into the electromyography.)

On the claim,

- report 95863 (Needle electromyography; three extremities with or without related paraspinal areas) for the electromyography.

- report 64470 (Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; cervical or thoracic, single level) for the injection.

- attach ICD-9 code 340 (Multiple sclerosis) to 95863 and 64470 to prove medical necessity for both procedures.
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