Otolaryngology Coding Alert

Question: What diagnosis should I use when the physician performed 42415, and the assisting physician used a NIM monitor?

Nevada Subscriber

Answer: Most payers do not pay for neuro monitoring even when it is done by another physician. The diagnosis used is the diagnosis documented. If a payer has a limitation on the diagnoses and pays for the monitoring, the diagnoses will be specific to the payer. This means you need to indicate what is documented.

Tip: Find out from your biggest payers if they ever pay for the monitoring or if they have a policy limiting the diagnoses. Medicare, however, never pays for the monitoring.